HCV is a prevalent—and deadly—coinfection among people living with HIV/AIDS, especially people who inject drugs. An estimated five million people are HCV-coinfected – although surveillance data in many low- and middle-income countries range from limited to nonexistent.
"HIV increases the risk for, and rate of progression to liver cirrhosis; and end-stage liver disease secondary to HCV co-infection is a leading cause of death among HIV-positive people who have access to antiretroviral therapy", says José Luis Castro, Interim Executive Director of The Union. A failure to address HCV therefore potentially undermines global efforts to address HIV and TB.
Recently, UNITAID issued a call for letters of intent (LOIs) on market-based interventions to increase access to key treatment, diagnostic and preventive commodities for HIV, tuberculosis and malaria. For the first time, the call for LOIs included the possibility of addressing hepatitis C virus coinfection with HIV.
While commending UNITAID for the inclusion of HCV in its 2013–16 Strategic Plan, the TAG campaign asks UNITAID to speed up its efforts to support interventions that address HCV coinfection, given the scope of the HCV pandemic and current lack of a global response. Specifically, it asks UNITAID to promptly provide full support for exploratory analyses seeking to:
• Make affordable treatment regimens available for HIV/HCV coinfections
• Consolidate demand, and negotiate prices for key HCV diagnostics
Delays in focusing on these objectives will cost lives and impede scale-up when more effective and tolerable therapies are available, according to TAG.
Hepatitis C is curable – that is patients can achieve an outcome known as sustained virological response or SVR – regardless of their HIV status. In HIV/HCV-coinfected people – even those with cirrhosis – SVR is associated with improved tolerance of anti-retroviral therapy and decreased liver-related and AIDS-related illness and death.
"We have learned that it is possible to scale up delivery of lifesaving treatment for TB and HIV in low- and middle-income countries", says Castro, "and UNITAID has been instrumental to this success. At The Union, we see the inclusion of HCV as a logical step to secure and extend this success".
Immediately addressing HCV coinfection will bolster UNITAID's main priority, according to TAG, since interventions to facilitate access to HCV diagnostics and treatment are essential to optimise HIV treatment outcomes for millions of people.
Learn more about the TAG campaign