Million people in India are affected with Hepatitis C virus and don’t even know they’re affected. There is an urgent need to address this issue and tackle it efficiently. In observance of World Hepatitis Day on July 28,2018, Sushil G Devare, Director, Diagnostics Research and Emerging Markets Initiatives, Abbott Labs, India discusses about the various clinical advantages of the HCV core antigen test and how patients can be connected to treatments sooner. By Tanuvi Joe
Where is India when it comes to dealing effectively with HCV and how is the governemnt tackling this issue?
The World Health Organization (WHO) estimates that between 6-12 million people in India have Hepatitis C virus (HCV), and majority don’t know that they are infected. India has earmarked INR 600 crore ($91.9m) for its National Programme for Control of Viral Hepatitis. The three year programme started in 2018. The programme is also focused on connecting those chronically infected with HCV to anti-viral treatment.
Why is HCV testing important for eradication of Hepatitis C virus?
Hepatitis C is a liver infection caused by the Hepatitis C virus. Hepatitis C can range from a mild illness lasting a few weeks to a serious, lifelong illness. Some people who are infected with HCV clear it from their bodies without treatment and do not develop chronic infection. Many people who are infected with HCV do not know it because they do not have symptoms, and chronic HCV can lead to serious health problems over time. Given these factors, the first step to eliminating HCV is testing. Access to testing is a critical first step to diagnosis and treatment.
Can HCV core antigen be considered as an alternative to HCV RNA monitoring and why?
Previously, the diagnosis of chronic HCV infection required patients to undergo multiple blood draws for different tests. The first is an anti-HCV antibody test, which takes less than half an hour, and can detect HCV infection. Because around 25-30 per cent of HCV infections are resolved by the body’s immune defence mechanism and do not need anti-viral treatment, another test, such as a HCV nucleic acid test (NAT) is needed to confirm active infection. However, the results of these tests—the anti-HCV antibody test and HCV NAT—are usually or often not available within the same doctor’s visit and could take several days. As an alternative to HCV NAT, Abbott has launched an HCV core antigen test that can confirm active infection, producing results in less than 40 minutes. Once the active HCV infection is confirmed, the patient can be enrolled in an anti-viral therapy regimen, which can lead to a cure infection within 8-12 weeks.
Will utilisation of HCV core antigen prove to be reliable and cost beneficial?
The HCV core antigen test is reliable and a fast diagnostic test that helps diagnose HCV in people with active infection. The HCV core antigen test is simple to perform, does not require highly skilled staff to perform compared to other tests. According to WHO and the European Association for Study of Liver Diseases (EASL) analyses and recommendations, HCV core antigen test is cost effective compared to nucleic acid test (NAT). The clinical advantages of the core antigen test include making the HCV testing more efficient by confirming active infections within one doctor’s visit, helping connect patients to treatment sooner.
How would you advise doctors and healthcare centers when it comes to the diagnosis and dealing effectively with HCV?
It all starts with encouraging people to get tested for HCV. Today, doctors are equipped with the right tools to detect HCV in one doctor’s visit, helping patients gets faster access to treatment