Eradication of HCV Dr. Uwe Schlenkrich Brussels, 14 th of June 2016 - - PowerPoint PPT Presentation

Eradication of HCV

• Dr. Uwe Schlenkrich

Brussels, 14th of June 2016

Personal Introduction

• Born 1957 in Erfurt in East Germany (GDR)
• Diagnosed with severe haemophilia in the first year
• Treatment with blood and plasma till the middle of the 60ies
• Followed by the treatment with cryoprecipitate till the fall of the wall, 1989
• Never had access to virus inactivated clotting factors till 1989
• HCV diagnosis in 1991

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• Dr. Uwe Schlenkrich

Causes of the HCV infection

Treatment with blood, plasma and cryoprecipitate

(not tested, not virus inactivated)

Epidemiology of HCV in Germany (East and West):

0,3 % of the population; 1 in 300 persons is infected

Risk of transmission is 1: 300 in blood or plasma transfusion or 1: 100 in cryoprecipitat

(made of 3 plasma donations)

Risk of transmission with high concentrates was 100% in the early 80ies

(pool of 10.000 and more plasma donations)

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risk time

East Germany

Risk for a PWH to get infected with HCV

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risk time

West Germany

1991

• HCV diagnosis

1995

• first treatment with Interferon for over one year

(side effects: sleepiness, tiredness, problems to focus)

2003

• combination treatment with Interferon and Ribavirin over 3 months

2010

• liver cirrhosis diagnosis

2012

• treatment with Interferon, Ribavirin and Telaprevir over 21 weeks

(side effects: irritation of the skin)

2013

• treatment with Interferon, Ribavirin iv. , Silibinin and Telaprevir over 26 weeks

(side effects: absolutely exhaustion)

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Personal experience with HCV

Successful treatment in 2014

September – December 2014: treatment with Sofusbuvir + Daclatasvir and Ribavirin

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Personal experience with HCV

WHO Model List of Essential Medicines in 2015

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• Dr. Uwe Schlenkrich

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We need regulations that make live saving medicines available for all patients for a reasonable price.

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Consequences of a successful treatment

• DAA are a miracle for the patients
• Virus free does NOT mean cure
• Many patients have already developed liver fibrosis or cirrhosis, with a higher risk

to develop a liver carcinoma

• Live long control is necessary

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Is HCV still a risk for People with Haemophilia?

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WHO 2015: Blood screening

• WHO recommends that all blood donations should be screened for infections prior to use. Screening should be

mandatory for HIV, hepatitis B, hepatitis C and syphilis. Blood screening should be performed according to the quality system requirements.

• 25 countries are not able to screen all donated blood for 1 or more of the above infections.
• Irregular supply of test kits is one of the most commonly reported barriers to screening.

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Prevalence of HCV Antibodies in a developing country

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Ways to produce safe clotting factors

• Collection of plasma for fractionation only in countries with a working health system
• Deferral of risky donors (MSM, IVD, prisoners)
• Testing (Antibodies, Antigens, PCR or surrogate markers)
• Virus inactivation and reduction (pasteurisation, SD inactivation and nano filtration)

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• Dr. Uwe Schlenkrich

Result: no transmission of HCV since the early 90th

Eradication of HCV in the population of PWH

• Dr. Uwe Schlenkrich

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Affordable access to Direct Acting Antiviral Hepatitis C Drugs Supply of safe blood components and virus inactivated clotting factors