In a Rapid Communication issued today, the World Health Organization (WHO) is announcing updates on co-administration of treatment for drug-resistant tuberculosis and hepatitis C (HCV). The evidence suggests that concomitant treatment for HCV and multi-drug resistant or rifampicin resistant TB (MDR/RR-TB) is feasible, with potential benefits outweighing the harms. Co-administration may increase MDR/RR-TB treatment success and reduce failures, losses to follow-up, and deaths. Adherence support for HCV treatment during MDR/RR-TB treatment is also acknowledged.
"Concomitant hepatitis C and drug resistant TB disease represents a major threat to the health of many individuals and their families worldwide," said Dr. Tereza Kasaeva, Director of WHO's Global TB Programme. "The availability of effective therapies for both diseases that can be safely offered at the same time will help improve health outcomes and save lives".
This rapid communication informs national TB programmes, hepatitis programmes, policymakers, and technical organizations supporting seamless integration and improving TB service quality at the country level.
The new edition of WHO consolidated guidelines on the treatment of TB and drug-resistant TB, with its accompanying Operational Handbook on Tuberculosis: Module 4: treatment, will include these updated recommendations and detailed results of the evidence review that guided the analysis.
While short-course oral direct-acting antivirals (DAAs) have revolutionized HCV treatment, with over 90% sustained virologic response rates, managing chronic HCV in multi-drug resistant or rifampicin resistant tuberculosis (MDR/RR-TB) patients remains a challenge due to varying national policies and practices. WHO solicited 'expert evidence' from clinical experts worldwide through a public call to bridge this knowledge gap.
WHO gratefully acknowledges the work of the Guideline Development Group members, the evidence reviewers, national TB programmes, WHO staff, technical and funding partners, community and civil society representatives, patients and their caregivers, and the clinical experts who contributed to the data to inform this update.
