It is estimated that nearly 100,000
people die annually in India from HCV infection and co-morbidities. Around 25%
of 18 million HCV patients in India are infected by Hepatitis-C genotype 1
virus. This has become a concern in many hospitals, health care workers and more so in dialysis centers,
trauma care centers and intensive care units, who frequently deal with blood
and blood products during the course of the treatments.
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| Source of Hepatitis C infection |
This is a complex issue
observed in the state run hospitals with limited resources and at the same time
the risks of operating on such patients with chronic hepatitis C infection can’t
be ruled and one needs to organize themselves for these special situations with
special provisions and protection measures.
“Who would like to get exposed to
the risk of acquiring hepatitis C infection while operating on patients with chronic
hepatitis C infections in our elective operation theaters?” Said an anesthetist, defending his stand of
cancelling an operation in a government run tertiary care hospital. The patient
and the surgeon were left with no other option. The patient was asked to choose
another hospital which can take up such operations. The fear of Hepatitis C
infection, is significant due to the lack of availability of appropriate and
affordable treatment within reach of the hospitals. Similar situation was there
in the past for the patients infected with HIV.
This is a complex issue
observed in the state run hospitals with limited resources and at the same time
the risks of operating on such patients with chronic hepatitis C infection can’t
be ruled and one needs to organize themselves for these special situations with
special provisions and protection measures.
In the
recent past the hope of curing hepatitis C infection is on the cards in many countries with
introduction of the new drug treatments. Harvoni, the fixed-dose combination of
ledipasvir-sofosbuvir of 90mg and 400mg, respectively, is an improved version
of Gilead’s Hepatitis-C drug Sovaldi or sofosbuvir, seems to be playing a major
role in the coming years. Biocon will be selling the generic Harvoni under
brand name CIMIVIR-L. The potential market size for these drugs could be Rs.500
crore or even Rs. 1,000 crores in the foreseeable future. This type of
treatment would cost Rs.63 lakhs in USA today for one individual. But the
Indian company is determined to supply this medicine at an affordable price
(< Rs. 70,000). In the absence of vaccination for the Hepatitis C infection,
there should be provision for the supply of these medicines with the help of
insurance to the health care workers. Hospital management should take a lead
and assure the health care workers that there is support for them in any
exposed gets hepatitis C infection during their service.
Pinjala R K
