Use only approved, tested drugs for Hepatitis C: Egypt experts

Ingy Deif, Tuesday 10 Jul 2012

In country that ranks first in Hepatitis C prevalence, Ahram Online gets the recommendations of experts at a global conference who urge reassessing treatments and sticking to globally-approved programmes

photo: Reuters

Experts from Egypt and all over the world gathered in Alexandria for the seventeenth annual congress of the Egyptian Society of Tropical Medicine, Infectious and Parasitic diseases (ESTIP) to discuss the challenges hepatitis C poses to the country.

The conference's message is clear and direct: a call to the experts, Ministry of Health and the society at large to avoid using unproven treatments.

Apparently a trend of using new drugs that have not been globally approved nor tested to ensure their suitability to the Egyptian patient has been taking root.

The latest infection statistics are staggering admits Dr Helmy Abaza, Proffessor of Gastroenterology, Alexandria University and ESTIP conference president.

The World Health Organisation estimated in 2011 that Egypt comes first worldwide in hepatitis C (HCV) prevalence, with more than 22 per cent suffering from the disease and a shocking yearly number of infections exceeding 165,000.

Nevertheless, Dr Abaza stressed that this should not be an excuse to rush into untested therapies. He suggests that the upcoming cabinet reassess HCV current treatment programmes and only provide globally-approved treatments.

Prompt, approved treatment
Indeed, the statistics shed light on how catastrophically common this virus is in Egypt, which can severely damage liver function. But hope and cure is also around the corner if the approved methods are used, according to the conference.

Dr Yousry Taher Proffessor of Gastroenterology, Alexandria University and ESTIP Conference Secretary General assured that cure rates from approved therapies reach up to 65 per cent.

The doctor urged medics and internists to recommend treatments promptly, without delay for other new drugs under research that have not been proven effective for Egyptians. In other words, they should initiate treatments as soon as possible, instead of waiting for drugs still undergoing studies.

In that same breath he points to a specific example. With regards to the most common form of the virus in Egypt - HCV genotype 4 - Protease Inhibitors used alongside Interferon and Ribavirin to raise cure rates, such as Telaprevir and Boceprevir, have not proven effective. In fact, they can result in severe side effects that may put the patients’ lives at risk.

One recommendation that the experts seemed to take as a given was directed to the Health Ministry: continue efforts to eliminate HCV using globally-approved therapies only.

"The classic dual treatment regimen composed of Peginterferon Alfa and Ribavirin is the optimal and only proven treatment for HCV genotype 4, and has undergone over 10 years of clinical trials in Egypt," said Dr Gamal Shiha, Professor of Gastroenterology, Mansoura University and Head of the Association for Hepatic Patients Care.

Are there guidelines that must be taken into consideration regarding the launch of new medications in this field?

Dr Yehia El-Shazly, Professor of Gastroenterolgy at Ain Shams University answers that any drug must be approved by at least two global organisations, such as the FDA and EMEA, before it is locally registered. This should ensure it has met all the criteria across the different phases in drug development. He further emphasised the importance of pre-registration clinical trials according to global standards.


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