Doctors in low- and middle-income countries say ‘yes’ to long-acting treatments for Hepatitis C
Coinciding with announcements from the World Health Organization that more than 3,500 people are dying daily from viral hepatitis infections, the Coalition for Global Hepatitis Elimination (CGHE) announces the publication of "Preferences and feasibility of long-acting technologies for treatment of hepatitis C virus in low- and middle-income countries: A survey of providers and policymakers" in the March Issue of the Journal of Viral Hepatitis. This study demonstrates a readiness by doctors in low- and middle-income countries to embrace long-acting treatment for hepatitis C in order to more effectively and efficiently deliver care.
This study, led by CGHE Chief Technical Officer Dr. Neil Gupta with investigators from nine other countries around the world, explores the acceptability and feasibility of long-acting technologies (LATs) for the treatment of hepatitis C virus (HCV) in low- and middle-income countries (LMICs). The study, which surveyed HCV treatment prescribers and policymakers, sheds light on the potential impact of LATs on improving linkage to care, treatment adherence, and outcomes in LMICs.
The research explored one-time intramuscular injection, subdermal implant, and transdermal patch as potential LAT options. A total of 122 providers and 50 policymakers from 42 LMICs participated in the survey. Among the key findings:
- 93% of providers expressed willingness to prescribe LAT.
- 72% of providers preferred LAT if provided at comparable efficacy, safety, and cost as current oral treatments.
- Injection was the preferred LAT option among providers who favored LAT over daily oral medication.
- Policymakers reported a high likelihood of including LAT in treatment guidelines and national drug formularies if efficacy, safety, and costs were similar to oral treatment.
These findings suggest that HCV LATs could play a pivotal role in advancing progress toward HCV elimination in LMICs by offering diverse treatment options. The proportion of individuals treated after diagnosis in LMICs is less than half of that of the proportion treated in high-income countries. LATs hold potential for a “one-and-done” treatment approach, perhaps even as a “test and cure” solution, with administration of LAT immediately following point-of-care HCV diagnosis and disclosure. LATs may also provide greater flexibility in terms of site of administration, including mobile clinics or non-traditional care settings (such as harm reduction centers). They have the potential to provide decreased needs for pharmacy distribution administration, decreased health system visits, and greater patient choice and autonomy.
"This is the first study to explore the interest and feasibility of potential LATs for HCV, such as one-time curative injections, from a provider and policymaker perspective. Our results show that LAT could transform HCV elimination efforts, particularly in LMICs where many patients are lost from care before completing treatment with current medications," said Dr. Gupta. "We hope these results express the urgency to accelerate development of and equitable access to these technologies"
Prof. Andrew Owen, a Principal Investigator for LONGEVITY and co-Director of the Centre of Excellence for Long-acting Therapeutics (CELT) said “Understanding the needs of patients and healthcare providers is critical to our development of long-acting products. The current work supports continued development of long-acting interventions for HCV and resulted from an international collaboration of investigators focused upon bringing potentially transformational new interventions to patients in LMICs.”
CGHE affirms its commitment to combining operational research and strategic information initiatives with policy and advocacy efforts to address barriers to viral hepatitis elimination globally. To access the full article, please visit the Journal of Viral Hepatitis.
This work was supported by funding through global health agency Unitaid’s project LONGEVITY; a partnership of seven organizations working to produce long-acting therapeutics options for the prevention and treatment of hepatitis C virus, tuberculosis and malaria in LMICs, led by CELT’s co-Directors, Prof. Andrew Owen and Prof. Steve Rannard (2020-38-LONGEVITY). The publication’s contents are the sole responsibility of the authors and do not necessarily represent the official views of the funder.
The LONGEVITY project aims to simplify TB, malaria and hepatitis C virus treatment and preventative treatment to reduce the drug burden and the number of patients requiring complex therapies for active disease.
Find out more about the LONGEVITY project
The LONGEVITY Project is funded by global health agency Unitaid
The project also involves critical partners and collaborators in the Clinton Health Access Initiative, Johns Hopkins University, Medicines Patent Pool, Tandem Nano Ltd., Treatment Action Group and the University of Nebraska Medical Center
