Globally, 2.3 million people are co-infected with HIV and hepatitis C. For people living with HIV, hepatitis C is a leading cause of death, due to the faster progression of the disease and the higher chance of cirrhosis and liver cancer. However, hepatitis C is curable.

In Mykolaiv, in the south of Ukraine, MSF is taking an integrated approach to hepatitis C care for people living with HIV, by providing free diagnostic tests, treatment with new drugs, and education and counselling services to increase patients’ chances of success.

The recent test results from patients who finished treatment since the start of the activities one year ago are extremely positive, with a success rate of over 95 per cent in curing hepatitis C in patients who are also infected with HIV.

Shorter treatment with new oral drugs

“A hepatitis C infection can be deadly if untreated, especially for people living with HIV, but these test results remind us that a cure is possible,” said Franking Frias, MSF medical coordinator in Ukraine.

“For treatment we use sofosbuvir and daclatasvir, new oral drugs recommended by WHO that can cure hepatitis C in as little as 12 weeks with few adverse effects. In comparison, older hepatitis C treatment models use injectable drugs and take at least four times as long.”

The role of peer educators

But undergoing hepatitis C treatment can still be a challenge for many. Therefore, MSF is working with peer educators, who have themselves lived with the disease. They help patients manage their treatment and give advice on how to cope with challenges that may affect their ability to complete treatment, such as discrimination, financial difficulties and mental and physical hardships.

This has proven successful. So far, zero patients in the MSF project have failed to complete treatment as a result of missed doses or visits.

In total, 341 patients on antiretroviral therapy for HIV have finished MSF’s hepatitis C treatment course. A preliminary group of 143 patients have already undergone testing, and all but one patient was found to be cured of hepatitis C.

An example for the country

About two million people live with hepatitis C in Ukraine, but most lack access to affordable diagnostics and treatment for the curable disease. MSF’s hepatitis C treatment project in Mykolaiv will treat a total of 1,000 patients for hepatitis C, of whom 750 are co-infected with hepatitis C and HIV.

“The aim of our project is to provide an example of how hepatitis C can be effectively treated in Ukraine, where access to diagnostics and treatment is currently quite limited,” said Jeri Driskill, field coordinator for the MSF project in Mykolaiv.