In India 1% population is affected with hepatitis C. Though it seems less as compared to other diseases, the sheer number of patients in terms of population is huge. Hepatitis C unlike the food borne viruses hepatitis A and E does not present with jaundice. It present directly when the liver is shrunken and cirrhotic. So it is of utmost importance to identify the infection early. Anybody who has been transfused before 2003 in India should get themselves tested as the virus was not screened before that time in India.
A study carried out in US showed that of 4.1 million affected, only 1.7 million get diagnosed, and only 388 are under care of doctors while only 40 are treated. If such is the scenario in US, it is expected to be worse in India.
The treatment of hepatitis C has always been difficult as it entailed weekly injections for a year and a drug with severe side effects. A lot of patients had to stop treatment because of side effects. Even after going through such a treatment the success for the treatment remain poor. With the conventional treatment of peg interferon and ribavirin the success remained nearly 40% for genotype 1 and 70% for genotype 3, the two most commonly found genotype in india.
Starting from 2011, the scenario for hepatitis C has changed. Newer drugs became available for the treatment and the duration of treatment became shorter. Two initial drugs, bocepravir and telapravir never made it to Indian market. However, in 2015 February, Sofosbuvir became available and that increase the treatment success rate to nearly 90%. But even after that drug, weekly injections were required in majority, which still had side effects.
This week two new drugs are launched in India and for the first time – Daclatasvir and Ledipasvir. A single pill with a combination of Ledipasvir and Sofosbuvir is available in India and that needs to be taken just for 3 months for the treatment with a treatment outcome of more than 95%. The treatment is injection free. Daclatasvir is another drug launched this week in India with similar benefits and minimal side effects. Indians have a major benefit as cost in India is 100 times cheaper than US and affordable to most of the people. The cost of monthly pill of Daclatasvir is less than 10000 INR and is just required for 3 months. The overall treatment cost two years back was nearly 3 lakhs has now fallen to around 60,000 INR.
The US has decided to eradicate the disease by 2030. With India getting the drug much cheaper now, a similar outcome in India can be expected.