Twenty years on, the women at the centre of the hepatitis C scandal
are still being treated poorly by the State that poisoned them, writes
Special Correspondent Michael Clifford
much should one group be forced to suffer at the hands of the State?
Last week we were given a glimpse of how a state agency can callously
target a highly vulnerable group in order to protect itself from
scrutiny. What has emerged is an example of spin over substance.
Just over a week ago, a story broke about the failure of the
Government to provide a vital drug to sick people. Hundreds of citizens
who suffer from the blood disease hepatitis C are in danger of
contracting irreversible liver damage or even dying. The anti-viral drug
that could save them, Sovaldi, has been shown to be highly effective.
As with all new drugs a cost/benefit analysis must be undertaken to
determine whether the health budget can afford it. However, because it
is regarded as a major breakthrough, an early access programme was
initiated in other countries to make it immediately available to those
most in need. No such programme exists in this country.
A hinge in the RNA genome of the virus that causes hepatitis C
works like a switch that can be flipped to prevent it from replicating
in infected cells. Scientists have discovered that this shape is shared
by several other viruses—among them one that kills cancer cells.
That’s Seneca Valley virus, which seems harmless to healthy human cells but lethal to cancer stem cells.
“Clearly we’d like to understand it better,” said Thomas Hermann,
professor of chemistry and biochemistry at the University of California,
Hermann’s research group has determined the molecular structure of
this critical switch in the Seneca Valley virus and found that it
matches the L-shaped switch in hepatitis C virus, which his group had previously described.
In a group of young users of injection drugs, recent maintenance
opioid agonist therapy with methadone or buprenorphine for opioid use
disorders, such as heroin addiction, was associated with a lower
incidence of hepatitis C virus (HCV) infection and may be an effective
strategy to reduce injection-drug use and the resulting spread of HCV,
according to a study published online by JAMA Internal Medicine.
The use of injection drugs is a main route of
transmission for HCV infection. Younger drug users are an important
group to target because they are at the core of HCV infections.
Interventions that can prevent HCV infections are vital. Previous
studies have suggested that opioid agonist therapy may reduce the
incidence of HCV infection but little was known about the effect of this
therapy in young drug users.
Our results suggest that treatment for opioid use disorders with maintenance opioid agonist therapy can reduce transmission of HCV in young adult injection drug users and should be offered as an important component of comprehensive strategies for prevention of primary HCV infection,” the authors conclude.
PESHAWAR: The provincial health department has appealed to the Peshawar High Court (PHC) to announce a final decision in the case of the purchase of substandard interferon injections so the medicine can be made available for hepatitis patients.
Around 4,000 patients of hepatitis B and C who cannot afford private treatment have been suffering for over six months due to the non-availability of interferon at public health centres in Khyber-Pakhtunkhwa.
The supply of the therapeutic drug has been suspended because a case is being heard in the PHC regarding the health department’s purchase and supply of low-quality interferon. Interferon vials worth Rs130 million had been purchased by the health department from a Lahore-based company in 2012 and supplied to all public healthcare centres. However, when the drug was tested at a private laboratory in Peshawar it was found to be below par.
Which drugs are safe to take for a woman while she is pregnant? If a woman becomes pregnant while on therapy is there a risk to the fetus? If a woman is pregnant, which drugs increase the risk of birth defects? To help guide medical providers and patients, the Food and Drug Administration (FDA) has established certain categories that for the most part define what is safe and what is not safe. But there are gray areas within most of the categories. This is why it is so important to seek medical advice—medical providers base decisions on a variety of factors, such as does the risk outweigh the benefit, personal experience using a certain drug and the latest medical research.
There are 185 million people worldwide (2.8%) infected with the hepatitis C virus. The virus has seven different strains called genotypes—numbered 1 through 7. The variance (nucleotides) between each genotype is approximately 30-35%. There are also variances (nucleotides) of about 15% difference between each genotype—these are called subtypes, further classified by alphabetic letters, i.e., genotype 1a, 1b. The test to find out the genotype and subtype is a blood test.
Subtype information is necessary in regards to HCV antiviral treatment. Some medications work better with some of the HCV inhibitors than with others. This is one of the reasons that multiple HCV inhibitors (protease inhibitors, NS5A inhibitors, polymerase inhibitors) are being combined to treat hepatitis C.
WASHINGTON, DC, October 24th, 2014: In September, Gilead
Sciences announced licensing agreements for sofosbuvir (Sovaldi) and
ledipasvir, two key hepatitis C drugs. Known as direct-acting antivirals
(DAAs), these drugs are included in international and national
treatment guidelines because they offer significant improvements over
Universities Allied for Essential Medicines (UAEM) expresses concern
over these agreements, as these licensing agreements ignore the key
middle-income countries that typically experience high burdens of
hepatitis C. Approximately 185 million people worldwide are living with
with hepatitis C and over 350,000 die annually due to the disease. These
deaths could be prevented if access to this life-saving medicine is
UAEM is an international, student-driven non-profit organization
dedicated to improving access to medicines worldwide through a
combination of university licensing practices, revolutionary research
and development practices, and empowering the voices of a new generation
of health and science professionals.
The voluntary licensing agreement will allow seven Indian
pharmaceutical companies to produce and sell generic versions of
sofosbuvir (Sovaldi) and ledipasvir. Sovaldi is currently marketed at US
$84,000 for a 12-week treatment course, out of reach for the vast
majority in low and middle income countries, even though it could cost
only US $68 and $136 to produce in generic form. Gilead’s combination with ledipasivir (Harvoni)
is set to sell for an even higher US $94,000 per 12-week treatment.
Increasing competition through generic production can effectively reduce
prices, increasing access to life-saving medicines for all.
While Gilead’s license is a step toward better access to hepatitis C
medicines, they still allow high prices to remain a barrier to a large
portion of those with hepatitis C. The licenses exclude 51 middle income countries
that account for 49 million people living with hepatitis C (or 1/4 of
the global burden). These potentially profitable emerging markets
are denied access to affordable generic versions of sofosbuvir. UAEM
is strongly concerned by the fact that Gilead’s licenses exclude 49
million of the most vulnerable patients from access to these lifesaving
The health ministry said Friday three people
have died after taking the hepatitis C drug Sovriad, and it has ordered
the distributor to revise the drug packaging to say usage should stop
when indicated by a patient blood test.
ministry also ordered the maker and distributor, Janssen Pharmaceutical
K.K., to notify doctors and hospitals in writing of the change.
The package insert already warns of possible deterioration of liver
function from use of the drug, known generically as Simeprevir Sodium.
The ministry directed the packaging also say usage should be
discontinued if a blood test indicates certain abnormalities.