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Abu Dhabi, UAEThursday 21 June 2018

Fight against Hepatitis C should be regional, Abu Dhabi conference hears

An integrated approach is needed between neighbouring countries to stop the spread of Hepatitis C, experts said.

Hepatitis C can be eliminated as a public health threat by 2030 if tackled regionally, audiences heard this weekend at the International Society of Addiction Medicine conference in Abu Dhabi.

The World Health Organisation global health sector strategy requires the reduction of new Hepatitis C infections by 90 per cent.

The WHO had previously called for an urgent global response and comprehensive public health approach to treat people at all levels of society.

“We have heard today that this is not an easy goal and sometimes it seems almost impossible,” said Hannu Alho, a professor of addiction medicine at the University of Helsinki. “What is the reason for that? It’s a hidden disease and sometimes patients do not know they are infected.”

There is no vaccine for hepatitis C but more than 95 per cent of patients can be completely cured within three months of treatment with antiviral medication. Yet only 20 per cent of those with hepatitis C knew they have the virus. Its symptoms may not be apparent for years.

The blood born virus is normally passed through exposure to small quantities of blood, often by injection drug use needles, unsafe health care and the transfusion of unscreened blood.

In the UAE, statistics from the National Rehabilitation Centre indicate that about 60 per cent of intravenous drug users have hepatitis C.

Patients at the centre found to be positive receive counselling and medical treatment for Hepatitis C, a policy that has been in place since the centre opened in 2002.

However, experts cautioned that problem must be tackled regionally.

“If you’re treating this successfully in the Gulf and you’re not focusing the intense exchange with neighbouring countries, like Pakistan and Egypt, then you will not successfully treat this illness,” said Dr Stephan Walcher, an addiction specialist from Concept Center for Addiction Medicine in Munich, Germany.

“An integrated approach is needed.”

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Read more:

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Last week, the National Rehabilitation Centre in Abu Dhabi was chosen as a WHO collaborative centre. It will provide regional substance abuse treatment guidelines, offer training workshops, lead regional research and implement WHO policies in the region.

The stigma of drug use stops people from seeking testing or treatment for Hepatitis C.

Changing attitudes towards substance abuse will help people come forward, said Dr Ahmed Elkashef, the head of the centre’s research and studies section.

“I think perceptions are changing, thanks to awareness campaigns and education,” said Dr Elkashef. “Addiction is disease of the brain and it’s a chronic disease. When a patient reaches the level of addiction that they have lost control over their decision making, they need help to heal and that takes time. We used to think a week of detox will take care of it but now we know that it takes up to two or three years sometimes.

“Society needs to start thinking differently about the addiction and appreciate that without help those people will just continue to be lost.”

Doctors and health care professionals have a responsibility to make the public aware that good treatment for Hepatitis C are available, said Dr Walcher.

“Let’s not forget that even if you do not like parts of the society you still have to treat it in order to focus on the public health of our countries,” he said. “Leaving out [people who inject drugs], leaving out the migrant population, leaving out subgroups will not help us treat the disease. Hepatitis C is much more than a hidden disease; it is a public health threat.”

Medication costs are expected to drop in the next two or three years. Previous medications were slow to treat the virus in the brain or neural fluids. Today, treatment reaches the virus in all parts of the body.

An estimated 71 million people around the world had chronic hepatitis C in 2015. About 399,000 people die every year from Hepatitis C, usually from cirrhosis or liver cancer.

“Please remember that Hepatitis C is actually the only addiction-related disease that can be cured with one little pill,” said Dr Alho. “We need more of this kind of open discussion. Even the addiction doctors do not know this disease well enough.”