Hepatitis C, all available therapies to fight it

The hepatitis C virus (Hcv) is’one of the leading causes of liver-related morbidity’and mortality’worldwide. An estimated 71 million people have chronic hepatitis C virus infection, a significant number of whom progress to cirrhosis or liver cancer.

More than 191,000 treatments have been initiated in Italy

More than 191,000 treatments have been started in Italy, and in the vast majority of cases they have ended successfully. But of concern are the approximately 250 thousand people who have contracted the infection and may not even know it. A world ‘submerged’ made up of the indigent, prisoners, drug addicts and immigrants, just to give a few examples, but also of those over 60 who are little aware of the degree of severity’ of the disease and the possibility’ of treating it.

In the past three years, meanwhile, the scenario of C virus liver disease therapy has profoundly changed, and with the availability of new drugs with direct antiviral action, it is now possible to cure most patients within a few weeks (with therapies that allow definitive elimination of the virus in about 97 percent of cases), regardless of the stage of the disease. A great achievement for clinical research, this one, which would now imply a new model should the costs of therapy fall fully to the regions.

Alliance Against Hepatitis 2019

This was discussed in Rome at the press conference ‘Alliance against Hepatitis 2019′, promoted by the scientific societies Aisf (Italian Association for the Study of the Liver) and Simit (Italian Society of Infectious and Tropical Diseases), under the sponsorship of EpaC Onlus. “If the costs of therapy were to be passed from the fund for innovative drugs to be fully borne by the regions,” said Professor Massimo Galli, president of Simit, “the regions would find themselves bearing additional direct costs, without sufficient investment having yet been made in the emergence of the underground, except for the scientific societies that have undertaken communication campaigns.

Possible equivalence of drugs

It must be remembered that the bulk of the undeclared resides in the age groups’above 50, in which very little has been done to date”. Another ’health policy thorn’ alarming the scientific community about hepatitis C’ also the ‘alleged’ equivalence of drugs. “We may in fact have to deal with a possible equivalence of drugs being evaluated by Aifa- continued Galli- The availability’in Italy of three different pharmacological treatments has made it possible in recent years to choose and use the therapeutic scheme most’suitable for each patient. The’possible assertion of equivalence among the available pangenotypic drug combinations would take away the discretion of physicians to implement the best therapeutic choice for each patient”.

Dr. Salvatore Petta, secretary of Aisf

Also according to Dr. Salvatore Petta, secretary of Aisf, “great caution” must be exercised in this regard, because ’such regimens contain “active ingredients belonging to different therapeutic classes-he let it be known-have different safety profiles in certain subpopulations of patients and are administered with treatment regimens that differ in duration depending on the viral genotype of Hcv and the severity’ of liver disease. Therefore, the’application in this clinical setting of the equivalence principle, if approved by Aifa, could invalidate what excellent work has been done so far, with potential negative repercussions both clinically and pharmacoeconomically”.

On the part of the institutions, however, there seems to be “maximum commitment to listen to the needs of clinicians and patients” finally reassured Raffaele Mautone, a member of the 12th Senate Committee on Hygiene and Health’ not to miss “a historic opportunity. To date we have supported research efforts and the’implementation of new therapies, we now hope for a continuation of this path, both for the health of individuals and for public health”.