TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
Médecins Sans Frontières Access Campaign, Geneva, Switzerland.
Curr Opin HIV AIDS. 2019 Jan;14(1):1-6. doi: 10.1097/COH.0000000000000514.
With increasing availability of generic direct-acting antivirals (DAAs) and associated price reductions, various governments, multilateral institutions, and donors have started providing testing and treatment for hepatitis C virus (HCV) infection. More data on the quality of these generic medicines and on cost-effectiveness of their use are becoming widely available. This review seeks to describe some of the treatment programs for HCV that are evolving in Cambodia, India, Indonesia, Malaysia, Myanmar, and Thailand.
The quality of multiple generic DAAs has been shown to be bioequivalent to innovator formulations, with generic versions achieving high cure rates in real-world settings. Although published materials are limited, there is expanding experience with local pilot and national treatment programs which are largely being funded by national governments and other institutions.
Countries and other public health stakeholders are recognizing the need to scale up HCV diagnosis and treatment programs using generic DAAs. However, local pilot or national treatment programs need to be massively expanded to eliminate HCV in high-burden areas.
目的综述:随着越来越多的通用直接作用抗病毒药物(DAAs)的出现和相关价格的降低,各国政府、多边机构和捐助者已开始提供丙型肝炎病毒(HCV)感染的检测和治疗。关于这些仿制药的质量和使用成本效益的更多数据也越来越广泛地被获取。本综述旨在描述柬埔寨、印度、印度尼西亚、马来西亚、缅甸和泰国正在演变的一些 HCV 治疗方案。
最近的发现:多项通用 DAA 的质量已被证明与创新制剂具有生物等效性,仿制药在真实环境中实现了高治愈率。尽管已发表的资料有限,但有关当地试点和国家治疗方案的经验正在不断扩大,这些方案主要由各国政府和其他机构提供资金。
总结:各国和其他公共卫生利益相关者认识到需要使用通用 DAAs 扩大 HCV 诊断和治疗方案的规模。然而,需要大规模扩大当地试点或国家治疗方案,以消除高负担地区的 HCV。