Reply to Ozaras et al

Sulkowski, Mark S.; Brainard, Diana M.; Yang, Jenny C.; Gane, Edward

doi:10.1093/cid/cix213

Cited by 1 publication

(1 citation statement)

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“…The patient was resourceful and had done some reading -via Google -to note that the adverse effects of PEG-INF and ribavirin-based therapy were simply not going to work for him. What he also read was the January 2014 publication in the New England Journal of Medicine by Sulkowski et al entitled "Daclatasvir plus Sofosbuvir for Previously Treated or Untreated Chronic HCV Infection" (11). It was an open label phase 2 study of genotype 1, 2, and 3 patients with 12 or 24 weeks of sofosbuvir and daclatasvir.…”

Section: The Journey Of a Patient With Hepatitis Cmentioning

confidence: 99%

Access to Generic Medicines for Hepatitis C in South Africa: A Journey of Discovery

Sonderup

Spearman

2016

Medicine Access @ Point of Care

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prevalence given the inherent, albeit appropriate, barriers in place to ensure a safe blood supply (2, 3). While seroprevalence in the general population is estimated at approximately 1%, data are emerging that suggest significantly higher prevalence in vulnerable key populations. Unsurprisingly, seroprevalence rates of 40%-60% are being reported in cohorts of people who inject drugs (PWID) from metropolitan areas, such as the capital city, Pretoria, while a seroprevalence of 6% has been observed in Cape Town in men who have sex with men (4). Currently, a large study is being conducted serosurveying key vulnerable populations in South Africa. This study will provide better data on the seroprevalence rates in these high risk subpopulations. Another intriguing aspect is the epidemiology of hepatitis C in South Africa. While vulnerable populations pose an obvious risk for hepatitis C acquisition (e.g., PWID), many patients do not have such a risk. In fact, compared to many other countries, the overall rate of injecting drug use is low and it only accounts for about 8% of hepatitis C in sub-Saharan Africa, with South Africa being similar in this regard (5). In our own experience, blood or blood product exposure prior to 1992 accounts for about 30% of our hepatitis C patient population, who are often either hemophiliacs or women who received blood as a result of postpartum hemorrhage. Other risks, in our experience, include PWID, health care workers with percutaneous needle stick injuries, and, rarely, perinatal mother to child transmission. There is a significant number of patients (approximately 25%) who have no clear definable risk factor. South Africa is an ethnically and culturally diverse country. A measure of this

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Section: The Journey Of a Patient With Hepatitis Cmentioning

confidence: 99%