The cost of eliminating hepatitis C in Pakistan

Abbas, Zaigham; Abbas, Minaam

doi:10.1016/s2214-109x(20)30036-x

Cited by 17 publications

(19 citation statements)

References 8 publications

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“…Most of our study patients suffered from gastrointestinal disorders. This might be due to the high prevalence of hepatitis C (4.8%) in the Pakistani population-the second-largest affected population [ 15 ]. Hooker et al also concluded that ED visits were most commonly due to gastrointestinal symptoms [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Profile of Geriatric Patients Attending the Emergency Department of a Tertiary Care Hospital in Karachi: A Cross-Sectional Study

Mushtaq¹,

Abro²,

Sualeh³

et al. 2022

Cureus

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Section: Discussionmentioning

confidence: 99%

Profile of Geriatric Patients Attending the Emergency Department of a Tertiary Care Hospital in Karachi: A Cross-Sectional Study

Mushtaq¹,

Abro²,

Sualeh³

et al. 2022

Cureus

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“…Historically, the impact of this disease in countries like Pakistan has been exacerbated to a debilitating extent due to the non-existence of a sufficiently effective and affordable treatment regimen. In the past few years, the introduction of the recently approved direct acting antivirals (DAA) have renewed a sense of optimism among the clinicians in Pakistan and it is hoped that by 2030, a significant reduction in the hepatitis C prevalence will be achieved [2,3].…”

Section: Discussionmentioning

confidence: 99%

“…The burden of this disease in Pakistan is disturbingly high and it is second only to Egypt in terms of highest number of infections in a country. The reduction in this number is possible only by adopting a comprehensive test and treat strategy by the health authorities [2,3].…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Daclatasvir with Sofosbuvir and Ribavirin in Hepatitis C Virus Infection: A Real World Experience from South Punjab, Pakistan

Malghani

Chaudhary

Shahid

et al. 2021

Preprint

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Background & Objectives: Sofosbuvir (SOF) and daclatasvir (DCV) in combination with ribavirin (RBV) drastically changed the treatment scenario of chronic hepatitis C (CHC) patients, achieving remarkable efficacy and safety profile. Real world experience of SOF/DCV/RBV combination in this part of Asia was scant. This study aimed to evaluate the efficacy and safety of SOF/DCV/RBV combination to treat CHC patients at a tertiary care hospital in South Punjab. Methods: Patients of CHC of any genotype were enrolled prospectively. They were treated with 12 weeks course of SOF/DCV/RBV combination. Effectiveness was evaluated by end of treatment response (ETR) and sustained virological response (SVR) at 12 and 24 weeks post-treatment. Adverse events were recorded for safety analysis. Results: We analyzed data of 102 patients of CHC (40 males and 62 females). The mean age was 40.04 + 10.22 years. Mean weight was 67.24 + 11.78 kg, while mean body mass index (BMI) was 26.32 + 4.58 kg/m2. Eighty patients belonged to low socio-economic status, while 22 belonged to middle socio-economic status. Sixty-four had a rural background, while 38 were from urban background. Seventy-four patients had no co-morbid condition; 16 (15.7%) had diabetes and 12 (11.8%) patients had co-morbid hypertension. Ninety percent of the patients did not have cirrhosis; 6% had compensated liver disease, while 4 % had decompensated liver disease. All the patients achieved undetectable HCV RNA at the end of treatment and 12 weeks after completion of treatment, while SVR at 24 weeks was achieved in 98% of patients. Only 2 patients discontinued treatment as a result of side effects. The most common side effects reported include fatigue, headache and fever. Conclusion: CHC is a grave problem in developing countries like Pakistan. The SOF/DCV/RBV combination is very effective in eradicating CHC and has a very good side effect profile as well.

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“…Initiatives such as the Prime Minister’s Hepatitis C Control Program and the establishment of the National Blood Transfusion Authority in Pakistan are encouraging in that regard. 47…”

Section: Discussionmentioning

confidence: 99%

Assessing the potential cost-effectiveness of centralized vs point-of-care testing for hepatitis C virus in Pakistan: a model-based comparison

Babigumira

Karichu

Clark

et al. 2022

Preprint

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Background Pakistan has a hepatitis C virus (HCV) infection prevalence of 6-9% and aims to achieve World Health Organization (WHO) targets for elimination of HCV by the year 2030 through scaling HCV diagnosis and accelerating access to care. The clinical and economic benefits of various HCV testing strategies have not yet been evaluated in Pakistan. Objective To evaluate the potential cost-effectiveness of a reference laboratory-based (CEN) confirmatory testing approach vs a molecular near-patient point-of-care (POC) confirmatory approach to screen the general population for HCV in Pakistan. Methods We developed a decision-analytic model comparing HCV testing under two scenarios: screening with an anti-HCV antibody test (Anti-HCV) followed by either POC nucleic acid testing (NAT) (Anti-HCV-POC), or reference laboratory NAT (Anti-HCV-CEN), using data from published literature, the Pakistan Ministry of Health, and expert judgment. Outcome measures included: number of HCV infections identified per year, percentage of individuals correctly classified, total costs, average costs per individual tested, and cost-effectiveness. Sensitivity analysis was also performed. Results At a national level for a tested population of 25 million, the Anti-HCV-CEN strategy would identify 142,406 more HCV infections in one year and increase correct classification of individuals by 0.57% compared with the Anti-HCV-POC strategy. The total annual cost of HCV testing was reduced using the Anti-HCV-CEN strategy by $7.68 million ($0.31 per person). Thus, incrementally, the Anti-HCV-CEN strategy costs less and identifies more HCV infections than Anti-HCV-POC. Conclusions Anti-HCV-CEN would provide the best value for money when scaling up HCV testing in Pakistan.

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The cost of eliminating hepatitis C in Pakistan

Cited by 17 publications

References 8 publications

Profile of Geriatric Patients Attending the Emergency Department of a Tertiary Care Hospital in Karachi: A Cross-Sectional Study

Profile of Geriatric Patients Attending the Emergency Department of a Tertiary Care Hospital in Karachi: A Cross-Sectional Study

Safety and Efficacy of Daclatasvir with Sofosbuvir and Ribavirin in Hepatitis C Virus Infection: A Real World Experience from South Punjab, Pakistan

Assessing the potential cost-effectiveness of centralized vs point-of-care testing for hepatitis C virus in Pakistan: a model-based comparison

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