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WHO Issues Guidelines for Hepatitis C Treatment

New Hampshire state Laboratory Scientist set up a make shift lab at the middle school, Saturday, Aug. 11, 2012 in Stratham, N.H. The state Health Department set up the clinic to test hundreds of people for hepatitis C related to an outbreak at Exeter Ho
The World Health Organization is issuing its first-ever global guidelines on treating hepatitis C, a liver disease that kills between 350,000 and 500,000 people every year. WHO said the guidelines will reduce deaths from hepatitis C by helping countries improve treatment and care.

The World Health Organization said between 130 and 150 million people globally have chronic hepatitis C infection. The most affected regions are Central and East Asia and North Africa.

The hepatitis C virus is mainly spread through exposure to contaminated blood. This can happen through unsafe health care practices involving the re-use of needles and syringes. A significant number of people who are chronically infected with hepatitis C will develop liver cirrhosis or liver cancer.

WHO is publishing its guidelines as more effective and safer oral hepatitis medicines become more readily available on the market.

Stefan Wiktor, head of WHO’s Global Hepatitis Program, said hepatitis C can be treated and cured and, he said, treatments are getting better all the time.

“Up until recently, to treat someone with Hepatitis C required approximately 48 weeks of weekly injections of a medicine called interferon, which was very toxic, very difficult to take. It really discouraged people from taking the medicine," he said. "Now, the newer treatments are much shorter-12 weeks. Some of them are treated without any injections at all and result in more than 90 percent cure rates.”

Unfortunately, Dr. Wiktor said, most people in the world do not receive treatment for this illness. This is largely due to the lack of awareness of the problem and the lack of health care workers trained to recognize and deal with the disease.

However, he noted, the biggest problem is that most people do not have any symptoms. Therefore, they do not know they may be at risk and should be tested. He said the infection too often remains undiagnosed until serious liver damage has developed.

Another major problem is hepatitis C treatment is unaffordable for most patients. Dr. Wiktor said the newer drugs can cost as much as $84,000 for a 12-week course of treatment. He acknowledged price is a huge challenge to overcome.

“To bridge that gap between the promise of these new medicines and sort of the reality of low coverage, we are issuing-WHO is developing its first-ever treatment guidelines. And, these guidelines, since they come with the WHO seal of approval and are strongly evidence-based, we feel it will be an important tool for decision makers in countries who are considering starting or scaling up Hepatitis treatment programs to give them the recommendations that they can use to help guide the development of that program," Wiktor said. "Similarly, they can help health care workers on how to manage patients.”
The new guidelines provide recommendations on screening for hepatitis C infection, on medical care to slow the progress of the disease and on safe and effective treatments to cure chronic hepatitis C infection.

They also suggest measures that can be taken to prevent the transmission of the hepatitis C virus. These include instructions on safe medical procedures regarding injections in a health care setting and among people who inject drugs.

WHO officials said they are sure the price of treatment will come down dramatically as more people use and benefit from the new drugs. They note that treatment for HIV/AIDS used to cost $10,000 when it was first introduced. They said the same and better drugs now cost $100.00.

WHO said competition from generic HIV drug manufacturers, mainly in India, and the huge expansion of the market for these drugs has driven down prices, making it much cheaper for governments to scale up treatment. It said it expects a similar downward spiral in the price of hepatitis C drugs to occur.