Calls for more tailored treatment as new strain of hep C found in Uganda

Researchers have found three brand new strains of the hepatitis C virus in patients in Uganda in one of the biggest studies of the disease in sub Saharan Africa.

In 2016 the World Health Organization announced it wanted to to eliminate hepatitis C by 2030 but current treatments are developed for Western strains of the disease and there have been few studies to test whether they are effective against types found in other parts of the world.

Globally, an estimated 71 million people have chronic hepatitis C infection, 11 million of whom live in sub-Saharan Africa.

Researchers from the Wellcome Sanger Institute in Cambridge and the University of Glasgow screened the blood of 7751 people from the general population in Uganda.

The study in the journal Hepatology found undiagnosed hepatitis C in 20 of these patients and then sequenced their genomes alongside two samples from patients from the Democratic Republic of Congo.

The researchers discovered three completely new strains of the virus in addition to some strains seen in the west.

They also found that many of the strains carry mutations in genes known to be associated with resistance to some commonly used antiviral drugs.

The authors warned that there were likely to be other strains of the disease in other parts of the world.

Emma Thomson, one of the authors of the paper, said that there had been a "revolution" in hepatitis C treatment in recent years with the development of new drugs.

"There are now incredible treatment and cure rates of more than 95 per cent. We should be able to eliminate hepatitis C, however no one has look at the drugs' effectiveness in certain parts of the world, including sub-Saharan Africa," she said. 

"We don't need new treatments but we need to make sure that the treatments used are the right ones," she said.

A recent study of hepatitis C treatment in Rwanda showed a 54 per cent success rate for the treatment of one particular genotype, highlighting the need for targeted treatment.

"This success rate is well below what we would like to see," she said. 

Dr Manj Sandhu, a senior author on the paper from the Wellcome Sanger Institute and University of Cambridge, said:  “Our study highlights the need for more investment on people in Africa and developing parts of the world. We show there are clear differences in hepatitis C virus across the world, underlining the need for understanding hepatitis C globally."

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