Nowadays, the control of this disease is one of the major challenges in public health in the entire world: it affects between 150 and 200 million people and kills each year between 500,000 and 700,000 according to the World Health Organization (WHO).
In Spain, the number of infected people is estimated to be between 526,000 and 877,000 people and there are approximately 10,000 deaths per year.
The worse of these figures is that 7 out of 10 infected by hepatitis C, are not aware of it. The main reason is that hepatitis C is a silent disease: symptoms may take up to 30 years to appear, when the disease is already in advanced stages.
7 out of 10 infected by hepatitis C, are not aware of it.
Some people may have an acute clinical picture with fever, fatigue, lack of appetite, nausea, vomiting, abdominal pain, dark urine, faeces of greyish colour, pains in the joints and jaundice (yellowing of the skin and the whites of the eyes).
How do you get hepatitis C?
The Hepatitis C virus (HCV) is transmitted parenterally, through direct contact between the blood of an infected person and blood or mucous membranes (oral or genital) of another person. HCV can survive up to 3 days in a drop of blood. Therefore, Hepatitis C can affect any kind of people.
In particular, you can get it:
- By sharing utensils for personal hygiene, such as razor machines, toothbrushes, nail clippers, etc…
- Getting tattoos, piercings, dental care, hair cutting or acupuncture if you are not using disposable and individual material
- Sharing items that are used to suck up or injecting drugs
- Having received blood transfusions before 1991 in Spain or at any date in countries without adequate control of blood products.
- Maintaining sexual practices of risk
- By Vertical maternal fetal transmission.
You cannot get infected with any other practice that does not involve contact with blood as through food or water, through sneezing, hugging, kissing or holding hands.
Diagnosis and treatment
Due to its silent evolution, the diagnosis of hepatitis C infection is established, many times, when medical tests are conducted in the workplace or when blood doning, the carriers are discovered.
When the doctor suspects a disease in the liver, he requests a blood test to measure if there is an elevation of transaminases (substances contained in the cells of the liver) or the positivity of the antibodies against hepatitis C virus. Sometimes, the transaminase levels can remain normal for long periods of time. The study of the genetic material of the virus (viral RNA), using a test called PCR, indicates if the virus is “reproducing” actively in our liver. The study of subtype, this is the viral genotype, indicates the greater or lesser likelihood of the treatment being effective. Therefore, these two analyses are used when an antiviral treatment is going to be established.
Through an appropriate treatment prescribed by the hepatologist most cases of hepatitis C can be cured and the damage that the evolution of the disease causes in the liver stopped.
The strategy in the treatment is tailored to each case and taking into account the genotype of the Hepatitis C virus (the GT1 is the most common); the degree of fibrosis of the liver, the response to previous treatment, and other diseases that may have the patient.
In recent years there have been spectacular advances in the treatment against the Hepatitis C. In Spain, there are currently several drugs that are approved so that hepatologists have different treatment options available for all genotypes of the Hepatitis C and for all clinical situations of their patients.
Since 2014 in the US and other countries of the world, one can buy a medicine called sofosbuvir, marketed in most parts of the world with the trade name of Sovaldi. The great advantage of this medicine is that, although it is used in combination with other drugs, it only has to be taken during 12 to 24 weeks and in 90% of the cases, when the infection has already caused cirrhosis of the liver, and approximately 98% of the cases, when the infection is at an earlier stage, Hepatitis C can be cured.
In November 2014 Sovaldi was approved in Spain.
The problem with this medication is its cost.
A treatment of three weeks’ duration with Sovaldi (sofosbuvir) has a cost of $84,000 in the United States; and 60,000 euros in the European Union, some figures that exceed the health budgets of all the countries.
A situation which contrasts with that the past may 8th of 2015, the World Health Organization expanded the list of “essential drugs”, including five new drugs against hepatitis C, including sofosbuvir and Harvoni® (association of sofosbuvir and ledipasvir), in addition to several anticancer drugs and anti-tuberculosis drugs.
Spanish Healthcare System
Since January 2015, the Ministry of Health created a committee of national and international experts to develop the National Plan for the approach of the Hepatitis C.
Since then, more than 18,134 people affected by hepatitis C have been treated in the first half of the year with the new antiviral drugs that has cure rates higher than 90 %.
This is more than a third of the 51,900 that according to the National Plan for the approach of the Hepatitis C must get access to these latest generation drugs in the next three years.
The case of Egypt
Gilead, the pharmaceutical company, signed an agreement in 2014 with the Government of Egypt to provide sofosbuvir with a hard discount on the price fixed in the United States. The reason it was because Egypt is the country with the highest prevalence rate of Hepatitis C in the world.
In this context, Sanantur has organized a trip to Cairo, so that there, the people who suffer from Hepatitis C in Spain and the rest of the European Union, will be able to access to medication and health care at more affordable price.
For this purpose, Sanantur currently collaborates with various travel agencies and with medical and health care entities in Cairo.
Obviously, the treatment with Sofosbuvir needs to be added with pegylated interferon and ribavirin in cases where that combination may be still necessary.