Investment can help Pakistan eliminate hepatitis C, says study

The country has one of the highest rates of infection, with 700,000 new patients each year

A large investment of at least US$3.9 billion could help Pakistan meet the World Health Organization's (WHO) target for the elimination of Hepatitis C virus (HCV), according to research led by the University of Bristol.

The study is a collaborative effort between the University of Bristol, Médecins Sans Frontières, the Pakistan HCV Task Force, the US Centres for Disease Control and Prevention, Aga Khan University (AKU) and the Pakistan Kidney and Liver Institute.

Using mathematical modelling to provide the first country-level estimates of screening and treatment needed in Pakistan, as well as the costs of doing so, the study found that to eliminate HCV here by 2030, around 36 million people would have to be screened or re-screened annually, and around 660,000 will have to be treated each year. Achieving this target could mean preventing 5.8 million new infections and 390,000 deaths that would have otherwise occurred by 2030.

Pakistan has one of the highest rates of HCV infections in the world, accounting for over ten per cent of global HCV infections, so reducing infections is a public health priority. While the targets have been set, there is a lack of guidance on how to achieve the WHO elimination targets in low and middle income countries (LMICs).

One in 10 people is a hepatitis C carrier

According to Dr Aaron Lim from the University of Bristol, the models suggest that Pakistan's HCV epidemic is on the rise, with 700,000 new cases each year. He added that the situation is expected to worsen if interventions are not scaled up, since less than 14 per cent of those infected are aware of their status and even fewer are receiving treatment for the virus.

Professor Saeed Hamid at Aga Khan University added that the amount of investment needed to reduce infections was substantial, but the benefits would be equally substantial. He asserted that the matter would require cooperation between the public and private sectors to ensure the best pathways of care.

Dr Huma Qureshi, national lead for the prevention and control of viral hepatitis in Pakistan, claimed that there was a pressing need to raise awareness about HCV and educate people about its transmission and risk factors.

"Achieving HCV elimination is not just about reducing the number of people who are infected. Crucially, it is also about improving quality of life and population health through averting new infections and preventing cases of advanced liver disease, liver cancer and liver-related deaths," said Professor Peter Vickerman, a principal investigator of the study. He maintained that the study provided policy guidance that was relevant not just to Pakistan but also other low and middle-income countries fighting to eliminate HCV.

Published in The Express Tribune, February 22^nd, 2020.