x Abu Dhabi, UAEThursday 27 July 2017

New hepatitis cure is a step closer in UAE

New medication will soon be available in the UAE to treat the most resistant types of the hepatitis C virus.

DUBAI // New medication will soon be available in the UAE to treat the most resistant types of the hepatitis C virus.

The drugs were approved in May by the US Food and Drug Administration (FDA) and have been acclaimed for their response rates.

The drugs, telaprevir and boceprevir, are mainly used to battle the virus's first genotype, which is the most common strain in Emirati patients, said Dr M Azzam Kayasseh, a specialist in hepatology - dealing with the liver, pancreas and gall bladder - and gastroenterology at the Medical Clinic in Dubai.

Speaking at a conference yesterday, Dr Kayasseh said the medicines, which would be available in tablet form, were awaiting approval by local health authorities and were expected to be on the market by the end of this year.

Dr Salem Awadh, a gastroenterology consultant at Mafraq Hospital in Abu Dhabi, also expects the medicines to be approved soon, although he declined to give a specific date.

Not all patients will be able to use the new drugs.

"These are prescribed as an add-on and only in special cases - for example, when a patient has not responded to other types of treatment," Dr Kayasseh said.

The main reason for this, he said, was the new drugs' potentially severe side effects, which include anemia, rashes and nausea.

Currently, patients are treated with injections of pegaylated interferon once a week, along with ribavirin tablets. This treatment usually takes 48 weeks, Dr Kayasseh said, but the new drugs would cut that.

FDA reports say the drugs show positive results in 75 to 80 per cent of cases, where the hepatitis C virus was no longer detected in the blood 24 weeks after treatment ended.

That was between 20 and 40 percentage points higher than results with the traditional treatments.

Dr Awadh said the new drugs were direct-acting anti-virals.

"The existing drugs only boost the immune system, whereas the new tablets act directly on the virus," he explained.

Patients with the hepatitis C virus (HCV) often do not display symptoms and can carry the disease for many years without knowing it.

"There are more than five times the number of patients who don't know they carry the disease than those who are actually diagnosed with hepatitis C," Dr Awadh said. "You can have HCV for 20 to 30 years and not have any symptoms."

He said many doctors mistakenly relied on liver performance to determine the presence of the virus, rather than looking into the blood.

"Thirty per cent of patients with HCV have fluctuating liver functions," Dr Awadh said. "When they come to the practitioner they may think they have nothing because they are in a phase where the liver function is normal."

The virus could lead to cirrhosis of the liver if not treated at an early stage, Dr Awadh said.

This year MSD Gulf, an international pharmaceutical company with a base in the UAE, initiated the White Paper project to collect data and information on the prevalence of the virus in the Middle East.

Andrew Miles, the managing director of MSD Gulf, described hepatitis C as a "silent killer".

"In reality, 9.2 million people in the region have HCV today," Mr Miles said. "The alarming thing is that most of them are not aware they have the disease.

"Not only does this pose a risk for infecting other people, but this disease could eventually lead to further complications."

The study found that in the UAE, there are an estimated 37,000 to 92,000 people infected with the hepatitis C virus, or between 0.8 and 2 per cent of the population.

Of this, only half of the cases are thought to have been diagnosed. About 50 per cent of infections were thought to be acquired through blood transfusions carried out before 1992, when blood was not screened for the virus.

Egypt scored the region's highest rate of prevalence in the report, at 15 per cent.

Dr Awadh, who took part in the White Paper project, attributed the high figure to unhygienic practices at clinics and hospitals.

“Injections are passed on from one individual to another and the needles are not sterilised,” he said.

The traditional treatment of the virus typically costs between Dh50,000 and Dh80,000 if caught at an early stage, said Dr Mohammad Al Zaabi, a gastroenterology consultant at Zayed Military Hospital in Abu Dhabi.

“There are new direct acting agents that have been approved by the FDA and are expected to substantially improve the response rates,” he said.

However, should the virus become chronic, a live liver transplant typically costs about US$300,000 (Dh1.1 million).

The key to avoiding such invasive measures, Dr Kayasseh said, is early detection.

“It does not have to reach this point,” he said. “Patients must also continue following up with their doctors.”

mismail@thenational.ae