Dr.

PARVEEN MALHOTRA

MD,DNB
(GASTRO),MNAMS,FIACM,FICP,PGDD

PROFESSOR & HEAD

DEPTT. OF MEDICAL GASTROENTEROLOGY

THE CULPRIT- NO
VACCINATION
 REAL CAUSE FOR
FIGHT
Sources of Infection for Persons with Hepatitis C

Sexual 15%

Transfusion 10%
(before screening)

*Nosocomial;
Other* 5%
Injecting Health-care work
drug use 60% Unknown 10% Perinatal

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 Eight 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 inetially with standard
doses of Pegylated Interferon and Ribavarin.

1533 patients have completed treatment.

At present 20000 more patients are currently

on treatment.
 GENDER
DISTRIBUTION
 DEMOGRAPHICAL
PROFILE
MARITAL STATUS
 AGE
DISTRIBUTION
DISTRICT WISE
DISTRIBUTION
RISK FACTORS
SYMPTOMATOLOGY
 GENOTYPE
DISTRIBUTION
SIDE EFFECTS
 VIROLOGICAL
RESPONSE
% patients negative
Type of report
on HCV RNA report

4th week HCV RNA 90%

12th week HCV RNA 92%

End of therapy (24/48 weeks) 96%

Sustained Virological Response

90%
(SVR)
 COMPLIANCE RATE
Therapy adherence n %

Total enrolled patients 1500 100%

Total adherent among all enrolled

1402 93.46%
patients

Total non-adherent among all enrolled

98 6.54%
patients
HEPATITIS C HELPLINE
08950012900
CHEER LEADERS
CHEER COUPLE
 ACTIVE ROLE OF
NGOS
 AWARENESS BY
STAFF
 MOTIVATION FROM
TOP
SOFOSBUVIR- BROUGHT
A NEW
500 patientsHOPE
have been put on treatment

Majority were put on Triple therapy

Dual therapy Decompensated cirrhotic or on

patient will

RVR has been achieved in 95% of patients

Excellent Compliance rate

ENTRY OF LEDIPASVIR &
DACLASTAVIR
Became available on 20 December, 2015
TH

The real game changer in treatment of hepatitis C.

The initial cost was Rs 14,000/month and total
expenditure was Rs 42,000 with all viral load
testing and genotyping free, till SVR is achieved.
Now with persistent efforts it has declined to Rs
62,00/month and total expenditure is Rs 18,600.
The Aim is to get free availability of these drugs to
everyone in haryana.
 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- Myalgia, Anxiety,
Dyspepsia.
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.