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Bakshi S, Chattopadhyay P, Ahammed M, Das R, Majumdar M, Dutta S, Nath S, Ghosh A, Bhattacharjee U, Baskey U, Sadhukhan PC. Efficacy of Different Combinations of Direct-Acting Antivirals Against Different Hepatitis C Virus-Infected Population Groups: An Experience in Tertiary Care Hospitals in West Bengal, India. Viruses 2025; 17:269. [PMID: 40007024 PMCID: PMC11861515 DOI: 10.3390/v17020269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 02/03/2025] [Accepted: 02/05/2025] [Indexed: 02/27/2025] Open
Abstract
Hepatitis C virus (HCV) is a global public health problem, but advancements in HCV treatment have improved the cure rate. This study evaluated the effectiveness of direct-acting antivirals (DAAs) in HCV-infected patients from May 2021 to April 2023 in collaboration with tertiary care hospitals in West Bengal. The HCV viral load was monitored via qRT-PCR. Sanger sequencing was performed to determine the HCV genotypes. The clinicians prescribed the patient treatment regime. The maximum number of patients in the study population (N = 398) were compensated cirrhosis patients (46.28%). The overall SVR rate of the study population was 94.47%. The decompensated cirrhosis patients experienced the lowest SVR rate (88.89%). The maximum number of patients were prescribed sofosbuvir/daclatasvir (63.77%), and the lowest SVR rate (93.23%) was observed with this treatment regime. In the study population, GT-3 was the predominant (67.43%) circulating genotype, followed by GT-1 and -4. Among 398 patients, 22 (5.53%) were non-responsive to DAA treatment. Out of these 22 non-responder patients, 77.27% (n = 17) were GT-3-infected (3a:10; 3b:07), followed by GT-1 (1c: 04; 1b: 01). Thus, increasing numbers of DAA non-responsive cases among HCV GT-3-infected and decompensated cirrhosis patients may pose serious threats in the future.
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Affiliation(s)
- Sagnik Bakshi
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Partha Chattopadhyay
- College of Medicine & Sagore Dutta Hospital, 578 B.T Road, Kolkata 700058, West Bengal, India;
| | - Mahiuddin Ahammed
- IPGME&R and SSKM Hospital, SSKM Hospital Rd, Bhowanipore, Kolkata 700020, West Bengal, India;
| | - Raina Das
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Moumita Majumdar
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Supradip Dutta
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Shreyasi Nath
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Anwesha Ghosh
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Uttaran Bhattacharjee
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Upasana Baskey
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
| | - Provash Chandra Sadhukhan
- Indian Council of Medical Research, National Institute for Research in Bacterial Infections P-33, Scheme XM, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India; (S.B.); (R.D.); (M.M.); (S.D.); (S.N.); (A.G.); (U.B.); (U.B.)
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Teaima MH, Al-Nuseirat A, Abouhussein D, Badary OA, El-Nabarawi MA. Pharmaceutical policies and regulations of oral antiviral drugs for treatment of hepatitis C in Egypt-case study. J Pharm Policy Pract 2021; 14:106. [PMID: 34915937 PMCID: PMC8674831 DOI: 10.1186/s40545-021-00389-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 12/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are limited studies on the role of efficient regulatory mechanisms in facilitating greater access to Hepatitis C virus (HCV) treatment. Evidence to support the importance of effective pharmaceutical policies and regulations in improving access to oral viral drugs towards the elimination of HCV is needed. This study aims to explore the adequacy of the implemented pharmaceutical policies and regulations in Egypt and their role to improve the availability and affordability of direct-acting antivirals (DAAs) to achieve universal access to the treatment of HCV. METHODS The study adopts a qualitative methodology using desk review of regulatory and legislative information, literature review, and semi-structured interviews with key experts from the concerned governmental regulatory agencies, pharmaceutical industries, academic organizations, professional associations, civil society organizations, and clinicians who are working in researching treatments for hepatitis C. FINDINGS The common DAAs available in the market are Daclatasvir, Sofosbuvir, and Sofosbuvir-based direct-acting antiviral combinations. Fast-track medicines registration pathway for marketing authorization of DAAs is used to reduce market access time frames. The pricing policies are supplemented using price negotiation to set up affordable prices that led to a reasonable price for DAAs. Using Trade-Related Aspects of Intellectual Property Rights (TRIPs) flexibility and local production of quality generics DAAs at lower prices. In addition, political will and collaboration between the government, civil society, and pharmaceutical companies improved patients' access to affordable DAAs and succeeding hepatitis C treatment in Egypt. CONCLUSIONS The study findings indicated that the implemented pharmaceutical policies and regulations have an immense role in enhancing access to medicines towards the elimination of hepatitis C in Egypt.
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Affiliation(s)
- Mahmoud H Teaima
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Adi Al-Nuseirat
- Access to Medicines and Health Technologies Unit, World Health Organization Office for the Eastern Mediterranean Region, Cairo, Egypt.
| | - Dalia Abouhussein
- Pharmaceutics Department, Egyptian Drug Authority (EDA), Cairo, Egypt
| | - Osama A Badary
- Department of Clinical Pharmacy Practice, Faculty of Pharmacy, The British University in Egypt, Cairo, Egypt
| | - Mohamed A El-Nabarawi
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Chinese Herbal Medicine Ameliorated the Development of Chronic Kidney Disease in Patients with Chronic Hepatitis C: A Retrospective Population-Based Cohort Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:5319456. [PMID: 31871483 PMCID: PMC6906860 DOI: 10.1155/2019/5319456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/15/2019] [Accepted: 10/17/2019] [Indexed: 12/28/2022]
Abstract
Chronic kidney disease (CKD) is a serious complication affecting patients with chronic hepatitis. The effectiveness of CHM for the prevention of CKD in hepatitis patients remains unclear. Therefore, we conducted a retrospective cohort study to investigate the effectiveness of CHM in preventing the development of CKD in hepatitis patients. From a subdataset of the Taiwan National Health Insurance Research Database (NHIRD), we included 19,409 patients newly diagnosed with hepatitis B and hepatitis C between the years 2000 and 2010. After exclusion criteria and 1 : 1 propensity score matching process, we compared demographic factors, comorbidities, and correlated drugs between the CHM and non-CHM cohorts. Statistical analysis was applied to evaluate the differences in characteristic distributions and to compare the cumulative incidence of CKD between the CHM and non-CHM cohorts. This study showed that the patients suffering from hepatitis C with CHM treatment more than 90 days as an adjuvant therapy combined with western medical treatment modalities exhibited a decreased risk of developing CKD (hazard ratio (HR) = 0.40, 95% confidence interval (CI) = 0.21–0.76, p value <0.01). The Kaplan–Meier curve revealed a lower cumulative incidence rate of CKD (p value = 0.004) for the CHM cohort. For further reference, we herein offer the ten most frequently prescribed single herbs and herbal formulas; as such, Salviae miltiorrhizae and Jia-Wei-Xiao-Yao-San were the most commonly prescribed single herb and formula, respectively. This nationwide retrospective cohort study provides evidence that CHM is an effective adjuvant treatment to decrease the risk of developing CKD in hepatitis C patients.
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