World Health Organization (WHO) officials are issuing updated treatment guidelines for hepatitis C, which promote the transition to newer medicines that have recently come to the market.
WHO issued its first-ever recommendations on the treatment of hepatitis C virus (HCV) two years ago, but since then, several new medicines, specifically direct-acting antivirals (DAAs), have been approved. WHO officials also added these medications to their Model List of Essential Medicines.
In a prepared statement on the guidelines, WHO officials note that treatment with DAAs are generally short in duration (8–12 weeks), easy to take (as few as 1 pill per day), and have fewer adverse events than other hepatitis medications.
The new guidelines also provide guidance on which specific regimens should be used (called “preferred regimens”) based on a patient’s clinical history as well as the genotype of HCV (there are 6 genotypes). These preferred regimens simplify treatment decisions by recommending only 3 treatment regimens for patients without cirrhosis and an additional 2 for patients with cirrhosis.
The updated guidelines are intended to promote the scale-up of HCV treatment, particularly in low- and middle-income countries where few people currently have access to hepatitis treatment, despite also being where most people with HCV live. WHO recognizes that implementation of the recommendations may not be immediate, because the treatments can be expensive and the medicines are not yet approved in many countries.
The price of DAAs varies dramatically. The cost to treat a single patient in some high-income countries can exceed $100 000. However, following the introduction of generic versions of DAAs, the price in other countries, such as India, is less than $500 to treat a single patient.