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Thursday, October 22, 2020

Over 10 million patients, India’s 10-year Hepatitis C elimination deadline seems far

An estimated 0.5-1 per cent of the country's population (or 10-13 million people) suffers from Hepatitis C, according to scientists.

Written by Tabassum Barnagarwala | Mumbai | October 6, 2020 1:50:01 am
The disease is hard to detect because it remains asymptomatic for a long time before leading to liver cirrhosis or liver cancer. (File)

With a target to eliminate Hepatitis C by 2030, India has managed to put 50,000 people on treatment since 2018, when the National Viral Hepatitis Control Programme (NVHCP), was launched.

On Monday, as three scientists — Harvey J Alter, Charles M Rice (both from the US), and Michael Houghton (from the UK) — won the 2020 Nobel Prize for Physiology or Medicine for their work in identifying Hepatitis C virus, it was a reminder for India on the long road ahead to reach its elimination target.

An estimated 0.5-1 per cent of the country’s population (or 10-13 million people) suffers from Hepatitis C, according to scientists. The disease is hard to detect because it remains asymptomatic for a long time before leading to liver cirrhosis or liver cancer.

WHO estimates 4 lakh global deaths due to the virus each year.

Dr Akash Shukla, assistant professor, gastroenterology, at Mumbai’s KEM Hospital said, “The good part is that treatment has now become accessible because the government provides it free of cost. Earlier it cost lakhs to treat a Hepatitis C case. But the sad part is, we did not get any new patients since the lockdown.”

Hepatitis C treatment requires oral medication for 12 weeks; in severe patients it may extend to 24 weeks. In Maharashtra, where 350 such patients have been diagnosed, 180 have so far been put on treatment, but access to medicines became an issue due to the Covid-19 pandemic. “The pandemic has slowed down our screening process,” Dr Mahendra Kendre, from Maharashtra’s public health department, said. “We can’t screen in containment zones, but we are now taking a focussed approach to start screening high-risk populations such as HIV patients, blood transfusion patients, and prisoners.”

India launched NVHCP in 2018, two years after Punjab introduced a similar programme. Punjab has enrolled 87,000 patients since 2016, and 93 per cent of them have been cured, according to officials. “Since Punjab began the programme before the national programme, their cases before 2018 are not included in national NVHCP data,” said Dr Preeti Madan, NVHCP deputy director.

“Punjab has a larger burden of disease due to high drug-abuse and injectable drugs usage. They began a Hepatitis C programme much before the central programme, and the national programme is similar to what they did,” said Rekha Shukla, joint secretary, Ministry of Health and Family Welfare. Punjab was recording 900-1,100 new cases every month before Covid-19 struck. In March and April, case detection fell to 250-300.

Dr Gagandeep Singh Grover, who handles the Hepatitis C programme in Punjab, said, “When there was complete lockdown, OPD was stopped but treatment was not stopped. Now we have increased treatment centres to all HIV centres and nine central prisons. New treatment centres are screening (people from) high-risk groups.” The state has increased detection to 800-900 cases a month over the last three months, Grover said. Grover, also on national advisory committee, said the current cost of treating a Hepatitis C patient is Rs 3,000.

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