Keywords
Boceprevir; Hepatitis C; Telaprevir
Abstract
Introduction: The treatment of chronic hepatitis C has been dramatically altered by the development of Directly Acting Antiviral (DAA) agents. The first two of these agents, telaprevir and boceprevir have resulted in significantly improved Sustained Virologic Response (SVR) rates in previously difficult to treat genotype 1 patients in the West. There appears to be very limited use of these new DAA agents in South and South East Asia.
Objective: To assess obstacles to DAA use among hepatologists in South and South East Asia.
Methods: Hepatologists from South and South East Asia attending the International Gastroenterology and Hepatology Forum (IGHF) in Yangon, Myanmar in November 2012 were surveyed, using a questionnaire, regarding DAA usage.
Results: 67 hepatologists were included in this study. The doctors were from the following countries: Pakistan 24 (36%), Sri Lanka 2 (3%), Myanmar 25 (37%), Philippines 8 (12%), Laos 5 (7%), and Cambodia 3 (4%). Eleven doctors said DAAs were available in their country (3 from Philippines, 4 from Burma, and 7 from Pakistan) and 4 doctors from Pakistan had previously prescribed DAAs. When asked about obstacles to DAA use in their countries, the following reasons were cited: 1. High cost 54% (36), 2. Lack of availability 54% (36), and 3. Lack of relevance of these DAAs to the genotypes prevalent in their countries 12% (8).
Conclusion: Based on this sample of hepatologists representing six countries from the region, there appears to be limited DAA use in South and South East Asia. Issues relating to cost, availability, and efficacy in prevalent genotypes limited DAA use in this region. These issues need to be addressed both for the existing DAAs as well as for the array of newer agents in development
Citation
Ahmed F and Mehdi K. Barriers to Directly Acting Antiviral Agent Use for Chronic Hepatitis C in South and South East Asia. SM J Hepat Res Treat. 2015; 1(1): 1003. https://dx.doi.org/10.36876/smjhrt.1003