Emerging Market Special Report: Hepatitis C Virus in Brazil
Prevalence of the hepatitis C virus (HCV) in Brazil is estimated to be among the highest in the world; in addition, the country faces the challenge of treating a largely undiagnosed HCV-infected population. Chronic HCV infections are often asymptomatic for years, which is a key barrier to diagnosis and treatment. Further, the lack of timely treatment can increase the risk of severe liver complications such as cirrhosis and hepatocellular carcinoma. The primary goal of HCV treatment is to completely eliminate the virus from the patient’s body and thereby reduce or halt the progression of liver disease. Currently, the standard of care for chronic HCV infections in Brazil is a lengthy treatment course of pegylated-interferon -alpha (peg-IFN-?; Roche’s Pegasys or Merck’s PegIntron) plus ribavirin (Roche’s Copegus, Merck’s Rebetol, generics) or telaprevir- (Johnson & Johnson’s Incivo) or boceprevir- (Merck’s Victrelis) based triple therapy. The imminent approval and launch of follow-on direct-acting agents (e.g., Gilead’s sofosbuvir, Janssen/Medivir’s simeprevir, Bristol-Myers Squibb’s daclatasvir) is set to trigger a major shift in the treatment paradigm with the introduction of interferon-free therapy in Brazil; this market change is poised to drive an increase in treatment rates in this key emerging market.