This is in line with the World Health Organization’s (WHO) goal of eliminating hepatitis C by 2030.
According to WHO, there are five main strains of the hepatitis virus – A, B, C, D and E. Hepatitis B and C are the most common causes of death, claiming 1.4 million lives globally each year, and hepatitis C is a major cause of liver cancer and liver failure.
Speaking to FMT, Dr Muhammad Radzi Abu Hassan, the health ministry’s national head of gastroenterology and hepatology services, said the major medical breakthroughs in the treatment of the viral infection might shine a light on the seemingly gloomy situation.
He said Malaysia’s first success in curing the disease started around 2018 when the ministry managed to get compulsory licensing to bring in generic drugs for the direct-acting antiviral (DAA) treatment.
The DAA treatment, which is a combination of two drugs – Daclatasvir and Sofosbuvir – had successfully cured over 10,000 patients since it was first introduced.
“When DAAs, for example, Daclatasvir and Sofosbuvir, were first discovered back in 2015, the price of the branded medicine was exorbitantly high. The cost of using Sofosbuvir alone stood at RM300,000. Because of the price issue, we tried to negotiate with the manufacturer to bring down the price but they were not willing to do so.
“We had no choice but to use compulsory licensing to bring in the generic ones, which were more affordable.”
Before that, Radzi said, Malaysia had used a drug called pegylated interferon. “However, this drug was less curative and had many side effects. It is more or less like chemotherapy.”
He noted that fewer than 50% of patients who underwent treatment with pegylated interferon were cured, and only a small number of patients received this drug because of its side effects and high cost.
“Before pegylated interferon, we didn’t exactly have any treatment for the disease,” he said.
This year, amid the Covid-19 pandemic, Malaysia became the trailblazer in hepatitis C treatment, with a new affordable drug for treating hepatitis C, which Malaysia helped to develop.
The drug, Ravidasvir hydrochloride, is a result of a collaborative effort between Malaysia and the Drugs for Neglected Diseases Initiative (DNDi).
“Some time around 2018, Malaysia, in collaboration with DNDi and Thailand, ran a clinical trial known as STORM-C-1 for Ravidasvir,” Radzi said.
“The combination of the new discovery compound (Ravidasvir) with Sofosbuvir gives better results and outcome.
“The Sofosbuvir-Ravidasvir combination has a slight advantage over the previous combination (Daclatasvir-Sofosbuvir), especially for hepatitis C patients with other medical conditions such as HIV. We do not have to adjust the dose of the medicines to avoid complications.”
Apart from causing less drug-to-drug interactions, this new combination produces efficacy as high as other DAAs and is possibly more effective than the commonly used Sofosbuvir-Daclatasvir combination.
Ravidasvir was recently registered as an alternative to the existing DAAs available in Malaysia.
Despite the numerous milestones, he said, hepatitis C still poses a severe threat to the country.
“There is a reason why hepatitis C is known as the silent killer. Many chronic cases of hepatitis C are undiagnosed, as the infection often remains asymptomatic for many years.
“Because of the nature of the disease, there are many patients left undetected in the community. This is a problem that we have to tackle now.
“We need to reach out to this group, especially the high-risk populations, such as drug abusers, to ensure that we can achieve the goal of eliminating the disease by 2030.
“With highly curative and yet free treatment in place, all individuals, especially those who are at risk, should take this golden opportunity to seek care from us”, he added.
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