Browsing by Author "Deepak Amarapurkar"

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Consensus statement of HCV task force of the Indian National Association for Study of the Liver (INASL). Part I: Status report of HCV infection in India
(Elsevier, 2014) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Radha K. Dhiman; Rakesh Aggarwal; Shivram P. Singh; Deepak Amarapurkar; Anil Arora; Mohinish Chhabra; Kamal Chetri; Gourdas Choudhuri; Vinod K. Dixit; Ajay Duseja; Ajay K. Jain; Dharmesh Kapoorz; Premashis Kar; Abraham Koshy; Ashish Kumar; Kaushal Madan; Sri P. Misra; Mohan V.G. Prasad; Aabha Nagral; Amarendra S. Puri; R. Jeyamani; Sanjiv Saigal; Shiv K. Sarin; Samir Shah; P.K. Sharma; Ajit Sood; Sandeep Thareja; Manav Wadhawan
Globally, around 150 million people are infected with hepatitis C virus (HCV). India contributes a large proportion of this HCV burden. The prevalence of HCV infection in India is estimated at between 0.5% and 1.5%. It is higher in the northeastern part, tribal populations and Punjab, areas which may represent HCV hotspots, and is lower in western and eastern parts of the country. The predominant modes of HCV transmission in India are blood transfusion and unsafe therapeutic injections. There is a need for large field studies to better understand HCV epidemiology and identify high-prevalence areas, and to identify and spread awareness about the modes of transmission of this infection in an attempt to prevent disease transmission. © 2014 INASL.
Consensus statement of HCV task force of the Indian National Association for Study of the Liver (INASL). Part II: INASL recommendations for management of HCV in India
(Elsevier, 2014) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Shiv K. Sarin; Radha K. Dhiman; Rakesh Aggarwal; Shivaram P. Singh; Deepak Amarapurkar; Anil Arora; Mohinish Chhabra; Kamal Chetri; Gourdas Choudhuri; Vinod K. Dixit; Ajay Duseja; Ajay K. Jain; Dharmesh Kapoor; Premashis Kar; Abraham Koshy; Ashish Kumar; Kaushal Madan; Sri P. Misra; Mohan V.G. Prasad; Aabha Nagral; Amarendra S. Puri; R. Jeyamani; Sanjiv Saigal; Samir Shah; Praveen K. Sharma; Ajit Sood; Sandeep Thareja; Manav Wadhawan
The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab. Genotype 3 is the most prevalent type of infection. Recent years have seen development of a large number of new molecules that are revolutionizing the treatment of hepatitis C. Some of the new directly acting agents (DAAs) like sofosbuvir have been called game-changers because they offer the prospect of interferon-free regimens for the treatment of HCV infection. These new drugs have not yet been approved in India and their cost and availability is uncertain at present. Till these drugs become available at an affordable cost, the treatment that was standard of care for the whole world before these newer drugs were approved should continue to be recommended. For India, cheaper options, which are as effective as the standard-of-care (SOC) in carefully selected patients, are also explored to bring treatment within reach of poorer patients. It may be prudent to withhold treatment at present for selected patients with genotype 1 or 4 infection and low levels of fibrosis (F1 or F2), and for patients who are non-responders to initial therapy, interferon intolerant, those with decompensated liver disease, and patients in special populations such as stable patients after liver and kidney transplantation, HIV co-infected patients and those with cirrhosis of liver. © 2014 INASL.
Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection in 2015
(Elsevier B.V., 2015) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Radha K. Dhiman; Shiv K. Sarin; Shivaram P. Singh; Yogesh K. Chawla; Rakesh Aggarwal; Deepak Amarapurkar; Anil Arora; Vinod K. Dixit; Ajit Sood; Samir Shah; Ajay Duseja; Dharmesh Kapoor; Shalimar; Kaushal Madan; Gaurav Pande; Aabha Nagral; Premashis Kar; Abraham Koshy; Amarender S. Puri; C.E. Eapen; Sandeep Thareja
Overall prevalence of HCV infection in India has been estimated to be approximately 1.3% in the general population. Recent introduction of sofosbuvir in India at a relatively affordable price has led to great optimism about prospects of cure for these patients. This drug is likely to form the backbone of current and future treatment regimes for HCV infection, displacing pegylated interferon. Availability of directly acting antiviral drugs (DAAs) has necessitated revision of INASL guidelines for the treatment of HCV published in 2014, as has happened across the world. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. Since only one DAA, sofosbuvir, is available in India, only two sofosbuvir-based regimes are possible: either dual drug therapy in combination with ribavirin alone for 6 months or triple drug therapy in combination with ribavirin and pegylated interferon for 3 months. The utility of these regimes in various situations has been discussed. Availability of a few other newer DAAs, expected in 2016, is expected to lead to more widespread use of these agents. Current guidance will be updated once newer DAAs, newer evidence with DAAs and 'real-life experience' with use of DAAs accumulate in India. © 2015 INASL.