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In the Global Epidemic of Hepatitis C, Millions Await the Cure

February 24, 2016

Just as the development of highly active antiretroviral therapy spurred advocacy and finally action to extend treatment to people living with HIV in developing countries, the development of new direct acting antivirals that can cure the vast majority of patients with chronic hepatitis C infection has evoked a call to extend prevention and curative therapy to the millions living with the virus worldwide. As with HIV, most of these individuals do not know they are infected and live in low- or middle-income countries.

"We have powerful tools in hand and it is time to talk about the elimination of hepatitis B and C as public health problems," said Gottfried Hirnschall of the World Health Organization at a session here Tuesday. WHO is developing a hepatitis elimination strategy to be released later this year at the World Health Assembly with targets to reduce rates of hepatitis caused deaths and new infections, Hirnshall said.

China, Pakistan, Nigeria, Egypt and India account for an estimated half of the up to 180 million hepatitis C infections worldwide, a global landscape of the the virus presented by Dr. Imad Waked of the National Liver Institute in Cairo showed. Across the world three to four million new infections occur annually.

While injection drug use drives the hepatitis C epidemic in the U.S., in most countries unsafe injections in healthcare contexts fuel the spread of the virus, which can survive 72 hours on surfaces and as long as 8 weeks in syringes and swabs. Clean needles alone don't address the risks because of the contamination of drug preparation equipment. Tragically, decades-long treatment campaigns for schistosomiasis in Egypt and vaccine campaigns in urban Cameroon generated high burdens of hepatitis C in these countries.

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