Current Pharmacotherapy Trends for Hepatitis C in the Hospitals of Faisalabad, Pakistan
Abstract
Abstract Views: 427
Hepatitis C infection is a global health issue. It is a growing challenge in Faisalabad, Pakistan, where at least 24% of the population is currently suffering from hepatitis C. If left untreated, HCV infection may lead to liver cirrhosis and hepatocellular carcinoma. The current study aimed to describe the various prescription trends of hepatitis C medication therapy in Faisalabad, Pakistan. It also aimed to evaluate the effectiveness of therapy and the satisfaction level of patients with their treatment. A comparative cross-sectional survey was carried out among patients receiving HCV medication therapy. For this purpose, a structured and close-ended questionnaire was completed by 270 patients. Comparative data analysis was performed based on selected variables, namely age, gender, marital status, current medication and its adverse effects. The prevalence of HCV in age group >40 was 63.3% and in age group <40, it was 36.7%. While, the prevalence of HCV in married individuals was 91% and its prevalence in unmarried individuals was 8.5%. Moreover, it was found that sofosbuvir was used by 24.8% of patients, daclatasvir was used by 24.4% of patients, entacavir was used by 0.4% of patients, acyclovir was used by 0.7% of patients, ribavirin was used by 7.8% of patients, and pegylated alpha 2b was used by 1.5% of patients. The trend of using combination therapy comprised interferon+ribavirin (1.5%) and velpatasvir+sofosbuvir (38.9%). The use of combination drug was found to be more common in patients of age group >40 (34.1%) than patients in age group <40 (8.8%). It was observed that lack of constant medical care and cost of therapy are major problems in the eradication of disease.
Downloads
References
Salari N, Kazeminia M, Hemati N, Ammari-Allahyari M, Mohammadi M, Shohaimi S. Global prevalence of hepatitis C in general population: A systematic review and meta-analysis. Travel Med Infect Dis. 2022;46:e102255. https://doi.org/10.1016/j.tmaid.2022.102255
Blach S, Terrault NA, Tacke F, et al. Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: A modelling study. Lancet Gastroenterol Hepatol. 2022;7(5):396–415. https://doi.org/10.1016/S2468-1253(21)00472-6
Alter MJ. Epidemiology of hepatitis C virus infection. World J Gastroenterol. 2007;13(17):2436–2441. https://doi.org/10.3748%2Fwjg.v13.i17.2436
Arshad A, Ashfaq UA. Epidemiology of hepatitis C infection in Pakistan: Current estimate and major risk factors. Crit Rev Eukaryot Gene Expr. 2017;27(1):63–77. https://doi.org/10.1615/CritRevEukaryotGeneExpr.2017018953
Piselli P, Serraino D, Fusco M, et al. Hepatitis C virus infection and risk of liver-related and non-liver-related deaths: A population-based cohort study in Naples, southern Italy. BMC Infect Dis. 2021;21:e667. https://doi.org/10.1186/s12879-021-06336-9
Liu L, Daftary MN, Alzahrani MS, Ohanele C, Maneno MK. Barriers to the treatment of hepatitis C among predominantly African American patients seeking care in an urban teaching hospital in Washington, DC. J Natl Med Assoc. 2021;113(2):147–157. https://doi.org/10.1016/j.jnma.2020.08.006
Hoofnagle JH, Seeff LB. Peginterferon and ribavirin for chronic hepatitis C. N Engl J Med. 2006;355:2444–2451. https://doi.org/10.1056/NEJMct061675
Hoofnagle JH. A step forward in therapy for hepatitis C. N Engl J Med. 2009;360:1899–1901. https://doi.org/10.1056/NEJMe0901869
Scott GM, Secher DS, Flowers D, Bate J, Cantell K, Tyrrell D. Toxicity of interferon. Br Med J (Clin Res Ed). 1981;282:e1345. https://doi.org/10.1136/bmj.282.6273.1345
Lisker-Melman M, Di Bisceglie AM, Usala SJ, Weintraub B, Murray LM, Hoofnagle JH. Development of thyroid disease during therapy of chronic viral hepatitis with interferon alfa. Gastroenterology. 1992;102(6):2155–2160. https://doi.org/10.1016/0016-5085(92)90348-3
Sharma SD. Hepatitis C virus: Molecular biology & current therapeutic options. Indian J Med Res. 2010;131:17–34.
Foster GR, Afdhal N, Roberts SK, et al. Sofosbuvir and velpatasvir for HCV genotype 2 and 3 infection. N Engl J Med. 2015;373(27):2608–2617. https://doi.org/10.1056/NEJMoa1512612
Lawitz E, Gane E, Pearlman B, et al. Efficacy and safety of 12 weeks versus 18 weeks of treatment with grazoprevir (MK-5172) and elbasvir (MK-8742) with or without ribavirin for hepatitis C virus genotype 1 infection in previously untreated patients with cirrhosis and patients with previous null response with or without cirrhosis (C-WORTHY): A randomised, open-label phase 2 trial. Lancet. 2015;385(9973):1075–1086. https://doi.org/10.1016/S0140-6736(14)61795-5
Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med. 2002;347:975–982. https://doi.org/10.1056/NEJMoa020047
Blach S, Zeuzem S, Manns M, et al. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: A modelling study. Lancet Gastroenterol Hepatol. 2017;2(3):161–176. https://doi.org/10.1016/S2468-1253(16)30181-9
Sievert W, Altraif I, Razavi HA, et al. A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver Int. 2011;31(s2):61–80. https://doi.org/10.1111/j.1478-3231.2011.02540.x
Sandesh K, Varghese T, Harikumar R, et al. Prevalence of Hepatitis B and C in the normal population and high-risk groups in north Kerala. Trop Gastroenterol. 2006;27(2):80–83.
Maan MA, Fatma H, Muhammad J. Epidemiology of hepatitis C viral infection in Faisalabad, Pakistan: A retrospective study (2010-2012). Afr Health Sci. 2014;14(4):810–814. https://doi.org/10.4314/ahs.v14i4.6
Jacobson IM, McHutchison JG, Dusheiko G, et al. Telaprevir for previously untreated chronic hepatitis C virus infection. N Engl J Med. 2011;364:2405–2416. https://doi.org/10.1056/NEJMoa1012912
Osmond DH, Padian NS, Sheppard HW, Glass S, Shiboski SC, Reingold A. Risk factors for hepatitis C virus seropositivity in heterosexual couples. JAMA. 1993;269(3):361–365. https://doi.org/10.1001/jama.1993.03500030059033
Guadagnino V, Stroffolini T, Rapicetta M, et al. Prevalence, risk factors, and genotype distribution of hepatitis C virus infection in the general population: A community‐based survey in southern Italy. Hepatology. 1997;26(4):1006–1011. https://doi.org/10.1002/hep.510260431
Tahan V, Karaca C, Yildirim B, et al. Sexual transmission of HCV between spouses. Am J Gastroenterol. 2005;100(4):821–824.
Vandelli C, Renzo F, Romanò L, et al. Lack of evidence of sexual transmission of hepatitis C among monogamous couples: Results of a 10-year prospective follow-up study. Am J Gastroenterol. 2004;99(5):855–859.
Ackerman Z, Paltiel O, Glikberg F, Ackerman E. Hepatitis C virus in various human body fluids: A systematic review. Hepatol Res. 1998;11(1):26–40. https://doi.org/10.1016/S1386-6346(98)00004-7
Sood A, Suryaprasad A, Trickey A, et al. The burden of hepatitis C virus infection in Punjab, India: A population-based serosurvey. PLOS One. 2018;13(7):e0200461. https://doi.org/10.1371/journal.pone.020046
Butt AA, Xiaoqiang W, Budoff M, Leaf D, Kuller LH, Justice AC. Hepatitis C virus infection and the risk of coronary disease. Clin Infect Dis. 2009;49(2):225–232. https://doi.org/10.1086/599371
Wong RJ, Kanwal F, Younossi ZM, Ahmed A. Hepatitis C virus infection and coronary artery disease risk: A systematic review of the literature. Dig Dis Sci. 2014;59:1586–1593. https://doi.org/10.1007/s10620-014-3222-3
Völzke H, Schwahn C, Wolff B, et al. Hepatitis B and C virus infection and the risk of atherosclerosis in a general population. Atherosclerosis. 2004;174(1):99–103. https://doi.org/10.1016/j.atherosclerosis.2004.01.010
Younas B, Khan G, Chaudhary M. Prevalence of diabetes mellitus among patients suffering from chronic liver disease. Mother Child. 2000;38(1):37–40.
Smith BC, Grove J, Guzail MA, et al. Heterozygosity for hereditary hemochromatosis is associated with more fibrosis in chronic hepatitis C. Hepatology. 1998;27(6):1695–1699. https://doi.org/10.1002/hep.510270631
Thorburn D, Curry G, Spooner R, et al. The role of iron and haemochromatosis gene mutations in the progression of liver disease in chronic hepatitis C. Gut. 2002;50:248–252.
Curry MP, O’Leary JG, Bzowej N, et al. Sofosbuvir and velpatasvir for HCV in patients with decompensated cirrhosis. N Engl J Med. 2015;373:2618–2628. https://doi.org/10.1056/NEJMoa1512614
Zamora JAG. Adverse effects of direct acting antivirals in HIV/HCV coinfected patients: A 4-year experience in Miami, Florida. Diseases. 2018;6(2):e51. https://doi.org/10.3390/diseases6020051
Hill A, Simmons B, Gotham D, Fortunak J. Rapid reductions in prices for generic sofosbuvir and daclatasvir to treat hepatitis C. J Virus Erad. 2016;2(1):38–40. https://doi.org/10.1016/S2055-6640(20)30691-9
Afzal MS. Hepatitis C virus and interferon-free antiviral therapeutics revolution: Implications for Pakistan. Viral Immunol. 2017;30(4):252–257. https://doi.org/10.1089/vim.2016.0164
Copyright (c) 2023 Madeeha Fatima, Aamna Habib, Faiza Habib, Kashaf Saleem, Ramsha Riaz, Sana Gulnaz, Aqsa Ahmed, Zaryab Fatima, Momina Shahid, Sadaf Waseem, Nayab Sajid, Aneeb Nadeem
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal
