Hepatitis-2015 Orlando, USA July 20 - 22 2015 Parveen Malhotra

Epidemiological Profile Of Patients At a New Hub Of Hepatitis C in India Dr. PARVEEN MALHOTRA MD,DNB (GASTRO),MNAMS,FIACM,FICP,PGDD PROFESSOR & HEAD DEPTT. OF MEDICAL GASTROENTEROLOGY PGIMS, ROHTAK

THE CULPRIT- NO VACCINATION

REAL CAUSE FOR FIGHT

Sources of Infection for Persons with Hepatitis C Sexual 15% Transfusion 10% (before screening) *Nosocomial; Health-care work; Perinatal Other* 5% Injecting drug use 60% Unknown 10% Source: Sentinel Counties, CDC Source: Centers for Disease Control and Prevention

Indian Scenario Nearly 12.5 million Indians are suffering from Hepatitis C affecting the liver. Over one lakh people get infected every year in India, according to the Indian National Association for the Study of Liver (INASL) study. Every 15th carrier of the HCV is an Indian, according to a recent report and it is responsible for as many as one in four cases of liver cancer and chronic liver disease.

HARYANA SCENARIO Initially in Haryana , the prevalence of Chronic hepatitis C was thought to be comparable to other parts of India. Now the prevalence has drastically increased and is reaching the levels of areas with high incidence like Manipur and Punjab. There are certain districts like Jind , Kaithal, Fatehabad, Panipat, Karnal and Sonepat where Prevalence is touching even 40-50%.

GOOD NEWS FOR HARYANA Haryana has become the first state of India where a separate, dedicated centre has been started under Department of Medical Gastroenterology, PGIMS, Rohtak. Free treatment of Chronic Hepatitis C has been started for patients belonging to BPL/SC and at subsidized rates for general population.  Twenty thousand patients have been screened over different parts of haryana.

HEALTH TALKS

HEALTH LECTURES

MEDIA INTERACTIONS

BILONA VILLAGE

AWARENESS TALK AT DERAS

DHABI TEK SINGH VILLAGE

Patients were treated with standard doses of Pegylated Interferon and Ribavarin. Up till now 1500 patients have completed treatment. At present 1500 more patients are currently on treatment.

GENDER DISTRIBUTION

DEMOGRAPHICAL PROFILE

MARITAL STATUS

AGE DISTRIBUTION

DISTRICT WISE DISTRIBUTION

RISK FACTORS

SYMPTOMATOLOGY

GENOTYPE DISTRIBUTION

SIDE EFFECTS

% patients negative on HCV RNA report VIROLOGICAL RESPONSE Type of report % patients negative on HCV RNA report 4th week HCV RNA 60% 12th week HCV RNA 92% End of therapy (24/48 weeks) 96% Sustained Virological Response (SVR) 90%

COMPLIANCE RATE Therapy adherence n % Total enrolled patients 1500 100% Total adherent among all enrolled patients 1402 93.46% Total non-adherent among all enrolled patients 98 6.54%

HEPATITIS C HELPLINE 08950012900

CHEER LEADERS

CHEER COUPLE

ACTIVE ROLE OF NGO’S

AWARENESS BY STAFF

MOTIVATION FROM TOP

SOFOSBUVIR- A NEW HOPE Up till now 200 patients have been put on treatment Majority are on Triple therapy Dual therapy – Decompensated cirrhotic or on patient will RVR has been achieved in 95% of patients Excellent Compliance rate

CONCLUSIONS Haryana has become new hub of Chronic hepatitis C in India. Majority of patients are male and belong to young age group i.e. 20-40 years of age group. Genotype 3 most common and Genotype 4 is more common in comparison to other parts of Northern India. Most common side effects- A.N. & Depression, Dyspepsia, Weight loss, Malaise, Generalized weakness. Good compliance and success rates are being achieved.

TAKE HOME MESSAGE Most important and first step is appreciation of problem. Next step is to prioritize resources in more prevalent areas. Development of Vaccine and Interferon free regimen is future dream for hepatitis C. Regular Screening camps and awareness in society is utmost need of hour to curb the menace of this disease. Do not wait till all resources are compiled- Start moving.

RATIONALE BASED TREATMENT Pseudo belief on Alternative Medicines. Anti HCV Vs HCV RNA based

ECONOMICAL TREATMENT STRATEGIES SCIENTIFIC AND RATIONALE BASED TREATMENT ROLE OF TREATING PHYSICIANS ROLE OF STATE AND CENTER ROLE OF NGO’S ROLE OF PHARMACEUTICAL COMPANIES ROLE OF MEDIA AND GENERAL POPULATION

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