Management of chronic hepatitis C at a primary health clinic in the high-burden context of Karachi, Pakistan

The burden of hepatitis C (HCV) infection in Pakistan is among the highest in the world, with a reported national HCV prevalence of 6.7% in 2014. In specific populations, such as in urban communities in Karachi, the prevalence is suspected to be higher. Interferon-free treatment for chronic HCV infection (CHC) could allow scale up, simplification and decentralisation of treatment to such communities. This study presents an interim analysis over the course of February-December 2015 of an interferon-free, decentralised CHC programme in the community clinic in Machar Colony, Karachi, Pakistan. It was concluded that the outcomes of HCV treatment with all oral combination in an integrated, decentralised model of care for CHC in a primary care setting, using simplified diagnostic and treatment algorithms, are comparable to the outcomes achieved in clinical trial settings for Sofosbuvir-based regimens. The study suggests the feasibility and the pertinence if interferon-free treatment regimens are included in the national programme, at both provincial and national levels.

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