The US Food and Drug Administration (FDA) recently announced that it has approved the new Egyptian drug Zepatier for treatment of certain types of chronic hepatitis C virus (HCV) in adult patients. The new medication could be a godsend for millions of Egyptians who either have the illness or are disposed to getting it. Egypt has the highest rate of HCV infection in the world. More than 150 million people around the world have hepatitis C, most of them in developing countries, putting them at risk of developing cirrhosis and liver cancer, according to World Health Organisation (WHO) estimates. Twelve million out of Egypt's 90 million people are infected with HCV. Each year there are 165,000 new cases in Egypt. The virus kills around 40,000 Egyptians a year. Wahid Doss is a professor of hepatology at the National Liver Institute and contributed to the research on Zepatier. He said the new drug has a success rate in hepatitis C patients ranging between 95 and 100 per cent. “Scientists tested the new medication on hepatitis types 1, 4, 5 and 6. We found that it was 96 per cent effective on patients with type 1 and genotype 4 by 97 to 100 per cent. Type 4 virus C is the most common type in Egypt,” said Doss. As Doss explained, most people infected with HCV show no symptoms until liver damage becomes apparent, which may take several years. Some people with chronic HCV infection develop cirrhosis over many years, which can lead to complications such as bleeding, jaundice (yellowish eyes or skin), fluid accumulation in the abdomen, infections or liver cancer. “FDA approval provides another oral treatment option for patients with genotypes 1 and 4 HCV infections without requiring use of interferon,” Doss said, adding that patients would receive Zepatier with or without ribavirin once daily for 12 or 16 weeks. Doss said the new generation of medication such as Zepatier is considered a great improvement and will help reduce the prevalence rate by three per cent over the next six years. “Within several years, Egypt can put an end to HCV by using the new medication, in addition to applying precautionary measures to reduce sources of infection.” Egypt has the world's highest prevalence of the virus. Out of 10 new infections, six occur in hospitals and clinics for various reasons. Others are infected at hairdressers and barbers because HCV can be spread through exposure to blood. Currently, Egypt is working to improve training on infection control for doctors and nurses. The aim is to stamp out unsafe medical practices such as reusing needles and other medical devices that should be discarded after a single use. But raising standards will also require further resources, Doss stressed. “A dentist in a poor rural area will probably spend more on sterilising his equipment than he earns from treating a patient,” he said. Public awareness is also of vital importance. Authorities are developing a communications campaign, with the support of UNICEF and WHO, to educate people about the importance of avoiding unnecessary injections and to insist that health workers use disposable syringes and needles in rural areas. “HCV is highly prevalent among drug addicts as they share needles and syringes for their required dose of drugs,” Doss added. Health Ministry spokesman Ihab Al-Ansari said Zepatier should not be given to patients with moderate or severe liver impairment. “The medicine will be available at all Health Ministry hospitals. Patients with virus C genotype 1 and 4 should apply to any ministry hospital to check whether the drug is suitable for them,” Al-Ansari said. The medicine was approved by the FDA in January and, according to Al-Ansari, will be available in the market in the next few weeks. Al-Ansari said that patients who suffer liver failure and need liver transplants are unlikely to benefit from the new drug, however, it can be useful for patients with less critical cases. Zepatier, Al-Ansari said, can reverse the damage done to the liver in five to seven years, provided that patients do not develop further complications and avoid weight gain, drinking and smoking. “Egyptian patients in particular must refrain from taking medicine that has no scientific basis. There are TV advertisements on herbs that claim to stimulate the liver even though they actually harm it,” Al-Ansari said.
