Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India

Puri, Pankaj; Anand, Anil C.; Saraswat, Vivek A.; Acharya, Subrat Kumar; Dhiman, Radha K.; Aggarwal, Rakesh; Singh, Shivram Prasad; Amarapurkar, Deepak; Arora, Anil; Chhabra, M. B.; Chetri, Kamal; Choudhuri, Gourdas; Dixit, Vinod Kumar; Duseja, Ajay; Jain, Ajay K.; Kapoorz, Dharmesh; Kar, Premashis; Koshy, Abraham; Kumar, Ashish; Madan, Kaushal; Misra, Sri Prakash; Prasad, M. N. Giri; Nagral, Aabha; Puri, Amarendra S.; Ramachandran, Jeyamani; Saigal, Sanjiv; Sarin, Shiv Kumar; Shah, Samir; Sharma, Praveen; Sood, Ajit; Thareja, Sandeep; Wadhawan, Manav

doi:10.1016/j.jceh.2014.05.006

Cited by 75 publications

(76 citation statements)

References 100 publications

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“…In patients on DAA without Peg-IFNa, EASL guidelines recommend HCV RNA monitoring at baseline, week 3 (assessment of adherence), week 4, week 12, or 24 (endof-treatment in patients treated for 12 or 24 weeks, respectively), and at 12 or 24 weeks after end-of-therapy. 3 However, unlike with Peg-IFNa/RBV therapy, there is little role for response-guided therapy during treatment with DAA.…”

Section: Evaluation and Management Of Hcv Infection In Resource-constmentioning

confidence: 99%

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Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. ( J CLIN EXP HEPATOL 2016;6:119-145) T here have been revolutionary changes in the management of chronic hepatitis C (CH-C) over the last few years. Pegylated interferon alfa (Peg-IFNa) plus ribavirin (RBV) therapy, which till the recent past was the standard of care, has been eclipsed by the arrival of newer directly acting antiviral agents (DAAs). Not only do the DAAs have better efficacy, they are also associated with lower side effects, have better tolerability, a shorter duration of therapy, and have simpler administration.In the recent guidelines issued by the American Association for the study of Liver Diseases (AASLD), in collaboration with the Infectious Diseases Society of America 1 and the European Association for Study of the Liver z (EASL), 2 the role of Peg-IFNa/RBV therapy in the management of HCV has been relegated to second-line, backup status. These newer guidelines, however, cannot be implemented in India as many of the recommended drugs are yet to be marketed in India. Other considerations for the treatment of HCV in India are a predominance of

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Section: Evaluation and Management Of Hcv Infection In Resource-constmentioning

confidence: 99%

“…The Indian National Association for Study of the Liver (INASL) had previously reviewed the epidemiology of HCV in India 3 and formulated the guidelines for HCV in India relevant to the available therapy in India. The initial guidelines were based on Peg-IFNa/RBV therapy.…”

mentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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“…6 Despite the low prevalence of HCV, India with its large population accounts for a significant proportion of the global HCV burden. 7 Approximately 12-18 million people are thought to be infected with HCV in India.…”

Section: Prevalence Of Hcv In Indiamentioning

confidence: 99%

“…In contrast, data from the western Indian states show a lower prevalence of 0-0.9% except for a few reports with higher prevalence. 6 Owing to the bias of self-selection, screening blood donors usually underestimates the real prevalence of HCV in a community.…”

Section: Prevalence Of Hcv In Indiamentioning

confidence: 99%

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Tackling the Hepatitis C Disease Burden in Punjab, India

Dhiman

Satsangi

Grover³

et al. 2016

Journal of Clinical and Experimental Hepatology

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Hepatitis C virus (HCV) is a globally prevalent pathogen and is a major cause of healthcare burden in India. HCV poses a significant problem in the state of Punjab, India owing to the higher prevalence of risk factors like unsafe medical practices (including unsafe injections and dental procedures) and intravenous drug use. The reported prevalence of HCV in this part of the country was 5.2% in 2012, while a recent study has shown the prevalence to be 3.2% in 2016. Similar to the other geographic belts in India, genotype 3 predominates in the state of Punjab. Control of HCV infection in Punjab requires focusing on several strategies. There is a need to formulate a health educational curriculum targeting not only the high-risk population but also the general population regarding the transmission of HCV. Training of family physicians who form the first link to patients in the community is imperative in the success of healthcare programmes. Adopting the dual approach of treating the old cases (decreasing the reservoir pool of HCV) and decreasing the incidence of new ones would help curtail the disease and decrease liver related mortality. A commendable initiative has been launched by the Punjab state government to eliminate HCV from Punjab. However, besides the initiative by the government, a concerted effort by all other stakeholders in managing the HCV burden in India, namely the doctors, the drug companies and the nongovernment organizations is required for control of HCV. ( J CLIN EXP HEPATOL 2016;6:224-232) H epatitis C virus (HCV) is a single stranded RNA virus belonging to the family Flaviviridae. It has six major genotypes 1-6 with genotype 1 being the most prevalent genotype globally (46%), followed by genotype 3 in 22% and genotype 2 and 4 in 13% each.

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Global Epidemiology of Chronic Hepatitis C Virus Infection

Özaras¹,

Leblebicioğlu²

2019

Viral Hepatitis: Chronic Hepatitis C

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Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India

Cited by 75 publications

References 100 publications

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Tackling the Hepatitis C Disease Burden in Punjab, India

Global Epidemiology of Chronic Hepatitis C Virus Infection

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