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Opinion Volume 4 Issue 1
Hepatitis C in Nepal
Sitaram Chaudhary
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Department of Gastroenterology, National Academy of Medical Sciences, Nepal
Correspondence: Sitaram Chaudhary, Department of Gastroenterology, National Academy of Medical Sciences, Nepal
Received: March 03, 2017 | Published: February 22, 2018
Citation: Chaudhary S,.Hepatitis c in Nepal. J Liver Res Disord Ther . (2018);4(1):00096. DOI: 10.15406/jlrdt.2018.04.00096
Abstract
Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. More than 200 million people worldwide have been infected with HCV. In the United States, conservative estimates suggest that more than 5 million people live with HCV. Unfortunately, HCV successfully evades the host immune response in 50% to 90% of acutely infected persons, thus leading to chronic infection in the majority of cases.
The estimated sero-prevalence of hepatitis C in Nepal is estimated to be from 0.1%-1.7% and very higher infections in IDU 94%. Many studies done among health blood donors in different regions of Nepal ranges from 0.11 to 0.16. Similarly, the seroprevalence of hepatitis C in healthy blood donors outside the Kathmandu valley ranges from 0.35 to 0.56. The most age group infected is 21-30 years followed by 31 to 40 yrs with the seroprevalence of 0.82 and 0.65 respectively.
In our experience at Bir Hospital, the most common mode of transmission was IVDU followed by tattoo, blood transfusion, and post dialysis. The most common genotype was 3 followed by 1. Till 2000, the burden of cost for the treatment of hepatitis C was very high but over the last few years, the treatment cost has reduced dramatically after DAA era.
We usually treat based on hepatitis C genotype result. Genotype 3 is treated with sofosbuvir and daclatasvir and genotype 1 is treated with sofosbuvir and ledipasvir with SVR result of over 90 percent. Recently, pangenotypic regime (sofosbuvir and velpatasvir) has been introduced as well to our market which has shown promising results regardless of genotype.
Conclusion
Hepatitis C infection is one of the most common causes of cirrhosis of liver. IVDU being the most common mode of transmission. Recently, due to advent of new DAA, there can be eradication of hepatitis C from developed nations as well developing nations like Nepal.
Acknowledgements
Prof. Anil K Mishra, Prof. Sudhamshu KC, Dr. Amrendra K Mandal (DM resident Gastroenterology).
Conflicts of interest
There is no conflict of interest.
©2018 Chaudhary. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.