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Antiviral Res. 2018 Feb;150:9-14. doi: 10.1016/j.antiviral.2017.12.001. Epub 2017 Dec 5.

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

Author information

1
Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University, Medical School, Samsun, Turkey. Electronic address: hakanomu@yahoo.com.
2
Internal Medicine and Infectious Diseases, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
3
Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey.
4
Infectious Disease Unit, University of Florence School of Medicine, Florence, Italy.
5
Infectious Diseases Service C Hospitalar São João, Faculty of Medicine, Alameda Professor Hernani Monteiro, Porto, Portugal.
6
Department of Medicine I, Bonn University, Bonn, Germany.
7
Infectious Diseases & Tropical Medicine and Research Lead, North Western Infectious Diseases Unit, Pennine Acute Hospitals NHS Trust, North Manchester General Hospital, Delaunays Road, Manchester, UK.
8
Department of Infectious Diseases, Örebro University Hospital, School of Medical Sciences, Örebro, Sweden.
9
Carol Davila University of Medicine and Pharmacy, Stefan S. Nicolau Institute of Virology, Bucharest, Romania.
10
Department of Gastroenterology and Hepatology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
11
Masaryk University, Infectious Diseases, Brno, Czech Republic; University Hospital Brno, Infectious Diseases, Brno, Czech Republic.
12
Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
13
Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista, Sevilla, Spain.
14
Rostov State Medical University, Rostov-on-Don, Russia.
15
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.
16
Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Slovenia.
17
Department of Infection Diseases, University Hospital Center, Tirane, Albania.
18
Infectious Diseases Department, South - Kazakhstan State Pharmaceutical Academy, Shymkent, Kazakhstan.
19
Division Hepato-Pancreatology 1st Department of Gastroenterology and Molecular Diagnostic Laboratory, "Szent György" Teaching Hospital Székesfehérvár, Hungary.
20
Department of Microbiology and Immunology, Azerbaijan Medical University, Educational Therapeutic Hospital, Baku, Azerbaijan.
21
Infectious Disease Clinic, University Clinical Centre of Kosova, Faculty of Medicine, Prishtina University, Pristina, Kosovo.
22
Department of Gastroenterology, University Hospital of Heraklion, Heraklion, Crete, Greece.
23
Service des Maladies Infectieuses, Faculté de Médecine de Tunis, Université Tunis EL Manar, Hôpital la Rabta, Tunis, Tunisia.
24
University Hospital of Infectious Diseases, Zagreb School of Medicine, Zagreb, Croatia.
25
Divisions of Gastroenterology and Hepatology of Clinical Pathology, University Hospital of Geneva, Geneva, Switzerland.
26
Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University, Medical School, Samsun, Turkey.
27
Infectious Diseases, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France.

Abstract

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.

KEYWORDS:

Availability of hepatitis C diagnostics; Therapeutics in European and Eurasia countries

PMID:
29217468
DOI:
10.1016/j.antiviral.2017.12.001
[Indexed for MEDLINE]

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