Publication details

Availability of hepatitis C diagnostics and therapeutics in European and Eurasia countries

Authors	LEBLEBICIOGLU Hakan ARENDS Joop E. OZARAS Resat CORTI Giampaolo SANTOS Lurdes BOESECKE Christoph USTIANOWSKI Andrew DUBERG Ann Sofi RUTA Simona SALKIC Nermin N. HUSA Petr LAZAREVIC Ivana PINEDE Juan A. PSHENICHNAYA Natalia Y. TSERTSWADZE Tengiz MATICIC Mojca PUCA Edmond ABUOVA Gulzhan GERVAIN Judit BAYRAMLI Ramin AHMETI Salih KOULENTAKI Mairi KILANI Badreddine VINCE Adriana NEGRO Francesco SUNBUL Mustafa SALMON Domonique
Year of publication	2018
Type	Article in Periodical
Magazine / Source	ANTIVIRAL RESEARCH
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1016/j.antiviral.2017.12.001
Keywords	Availability of hepatitis C diagnostics; Therapeutics in European and Eurasia countries
Description	Background. Treatment with direct acting antiviral agents (DAAs) has provided sustained virological response rates in > 95% of patients with chronic hepatitis C virus (HCV) infection. However treatment is costly and market access, reimbursement and governmental restrictions differ among countries. We aimed to analyze these differences among European and Eurasian countries. Methods: A survey including 20-item questionnaire was sent to experts in viral hepatitis. Countries were evaluated according to their income categories by the World Bank stratification. Results: Experts from 26 countries responded to the survey. As of May 2016, HCV prevalence was reported as low (<= 1%) in Croatia, Czech Republic, Denmark, France, Germany, Hungary, the Netherlands, Portugal, Slovenia, Spain, Sweden, UK; intermediate (1-4%) in Azerbaijan, Bosnia and Herzegovina, Italy, Kosovo, Greece, Kazakhstan, Romania, Russia, Serbia and high in Georgia (6.7%). All countries had national guidelines except Albania, Kosovo, Serbia, Tunisia, and UK. Transient elastography was available in all countries, but reimbursed in 61%. HCV-RNA was reimbursed in 81%. PegIFN/RBV was reimbursed in 54% of the countries. No DAAs were available in four countries: Kazakhstan, Kosovo, Serbia, and Tunisia. In others, at least one DAA combination with either PegIFN/RBV or another DAA was available. In Germany and the Netherlands all DAAs were reimbursed without restrictions: Sofosbuvir and sofosbuvir/ledipasvir were free of charge in Georgia. Conclusion: Prevalence of HCV is relatively higher in lower-middle and upper-middle income countries. DAAs are not available or reimbursed in many Eurasia and European countries. Effective screening and access to care are essential for reducing liver-related morbidity and mortality.