scholarly journals Minimum Costs for Producing Hepatitis C Direct-Acting Antivirals for Use in Large-Scale Treatment Access Programs in Developing Countries

2014 ◽  
Vol 58 (7) ◽  
pp. 928-936 ◽  
Author(s):  
A. Hill ◽  
S. Khoo ◽  
J. Fortunak ◽  
B. Simmons ◽  
N. Ford
2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Carissa E. Chu ◽  
Feng Wu ◽  
Xi He ◽  
Kali Zhou ◽  
Yu Cheng ◽  
...  

Abstract Background.  Hepatitis C virus (HCV) treatment access among human immunodeficiency virus (HIV)/HCV-coinfected people who inject drugs is poor, despite a high burden of disease in this population. Understanding barriers and facilitators to HCV treatment uptake is critical to the implementation of new direct-acting antivirals. Methods.  We conducted in-depth interviews with patients, physicians, and social workers at an HIV treatment facility and methadone maintenance treatment centers in Guangzhou, China to identify barriers and facilitators to HCV treatment. We included patients who were in various stages of HCV treatment and those who were not treated. We used standard qualitative methods and organized data into themes. Results.  Interview data from 29 patients, 8 physicians, and 3 social workers were analyzed. Facilitators and barriers were organized according to a modified Consolidated Framework for Implementation Research schematic. Facilitators included patient trust in physicians, hope for a cure, peer networks, and social support. Barriers included ongoing drug use, low HCV disease knowledge, fragmented reimbursement systems, HIV exceptionalism, and stigma. Conclusions.  Expanding existing harm reduction programs, HIV treatment programs, and social services may facilitate scale-up of direct-acting antivirals globally. Improving integration of ancillary social and mental health services within existing HIV care systems may facilitate HCV treatment access.


2021 ◽  
Author(s):  
Kao-Chi Chang ◽  
Shui-Yi Tung ◽  
Kuo-Liang Wei ◽  
Chen-Heng Shen ◽  
Yung-Yu Hsieh ◽  
...  

Abstract Background/Purpose of StudyClinical trials have demonstrated excellent efficacy and safety of pangenotypic direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV). However, there are limited large-scale real-world data on these pangenotypic DAAs. This study examined the results of two pangenotypic regimens, glecaprevir/pibrentasvir (GLE/PIB) and sofosbuvir/velpatasvir (SOF/VEL), in a real-world setting in Taiwan.MethodsAll HCV patients treated with GLE/PIB or SOF/VEL from August 2018 to April 2020 at the Chiayi Chang Gung Memorial Hospital were included. The primary end point was sustained virologic response 12 weeks after treatment cessation (SVR12). Adverse events (AEs) were also reported.ResultsA total of 1 356 HCV patients received pangenotypic DAA treatment during the study period: 742 patients received GLE/PIB and 614 received SOF/VEL. The rates of SVR12 for GLE/PIB and SOF/VEL were 710/718 (98.9%) and 581/584 (99.5%), respectively, by per-protocol analysis, and 710/742 (95.7%) and 581/614 (94.6%), respectively, by evaluable population analysis. Eleven patients (GLE/PIB: 8, SOF/VEL: 3) did not achieve SVR12. The most common AEs for GLE/PIB and SOF/VEL were pruritus (17.4% vs. 2.9%), abdominal discomfort (5.8% vs. 4.4 %), dizziness (4.2% vs. 2%), and malaise (3.1% vs. 2.9%). Laboratory abnormalities were uncommon, with <1% of patients exhibiting elevated total bilirubin or aminotransferase levels with both regimens. There were five drug discontinuations owing to AEs (bilirubin elevation: 3, dermatological issues: 2).ConclusionIn real-world practice, the pangenotypic DAAs GLE/PIB and SOF/VEL are effective and well tolerated, achieving high SVR12 rates for patients with all HCV genotypes.


2017 ◽  
Vol XX (XX) ◽  
pp. 1-4 ◽  
Author(s):  
Eric R. Yoo ◽  
Ryan B. Perumpail ◽  
George Cholankeril ◽  
Channa R. Jayasekera ◽  
Aijaz Ahmed

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