‘ We need to engage at all levels to reach this population’
THERE ARE TENS OF THOUSANDS OF PEOPLE in the UK who have already been diagnosed but have not yet been treated.
Some of these people will know that they have the virus, but are not engaging with treatment services for whatever reason. Others might have been tested at some point in their past and be unaware of their status.
To reach the first group, we need to understand that hepatitis C is a disease of vulnerable people
REMOVING BARRIERS
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Awareness initiatives can counter the fear of outdated treatment methods who might lead chaotic lifestyles, which means testing and treatment must be available where vulnerable people access care – not only GP surgeries but homeless shelters, needle exchanges, sexual health clinics, pharmacies and amongst the prison population.
To reach the second group, we need them to reengage with services entirely. We have highly effective medicines that can cure the virus and we need to get the word out there that it can be
HIDDEN HARM
Case study 3 cured. Raising awareness and fighting stigma is critical to the success of this ambition.
If people don’ t know they are at risk, they won’ t get tested or treated, risking serious health problems in the future. We have a moral obligation to do everything we can to reach this population of hepatitis C patients.
Prof Ashley Brown, vice chair of the Hepatitis C Coalition and hepatitis C lead for North West London
People often have no idea that they have hepatitis C when symptoms merge with a chaotic lifestyle
Change Grow Live( CGL)’ s national hepatitis C strategy aims to support all individuals who use or have used drugs intravenously to have regular access to finger-prick testing for the virus.
At the same time, preventative harm reduction advice is shared with atrisk populations by outreach teams working directly with people using drugs in high prevalence areas, on the streets or in hostel accommodation. For those who are aware that they have hepatitis C, CGL staff recognise that adverse reactions to previous treatment methods can be a barrier to re-engaging with treatment.
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Previously disaffected cohorts are much more willing to re-engage with treatment
In the recent past, some individuals opted to stop treatment prematurely rather than endure the painful side-effects of the medication. Even for those who completed treatment, the cure rate was variable.
At the beginning of July 2018, CGL promoted hepatitis C awareness across their treatment centres, explaining the importance of testing and the range of antiviral treatments now available.
Previously disaffected cohorts are much more willing to re-engage with treatment in the knowledge that the standard of care is different now.
Alesha in Northampton had previously been treated unsuccessfully with interferon injections, and had experienced multiple, serious side effects as a result. With the support of CGL, she began treatment with direct acting anti-viral tablets, and is now clear of hepatitis C.
Originally from South Africa, Billy has been living in London since 1988. While she was on a flight at the age of 18 she took her first sleeping tablet, and from then until 2010 she felt a sense of belonging through using various pills. Over the years Billy developed a long history of recreational and medicinal drug and alcohol misuse, including heroin, and battled with numerous mental health problems.
Almost ten years ago, and while still using drugs, she went to the Red Cross in Oxford Street to give blood. She had no symptoms of hepatitis C and was not expecting the positive result. When she had the news, doctors referred her to take part in the first trial for interferon treatment at St Mary’ s Hospital in London.
Billy recalls that at that stage in her life, everything was rather chaotic and it would have been difficult for her to detect if she had been experiencing any of the symptoms such as tiredness. She was unsure of how she contracted it, whether it was due to intravenous heroin-taking or from other blood transfusions in the UK and SA.
The treatment was painful and uncomfortable but it worked and cured Billy from hepatitis C. Despite periods of sobriety, it was only in 2010 with the support of DWP – now Turning Point Drug and Alcohol Wellbeing Service( DAWS) – that her life changed permanently for the better. She joined a day programme and became involved with the service-user involvement groups, and now runs a jewellery designing and making course at drug and alcohol services at Turning Point and CGL. She has recently completed her peer-mentor training and hopes to use her recovery journey to support others.
Billy has also received training from the Hepatitis C Trust and hopes to become involved soon in testing via dry blood spots at Turning Point services. www. drinkanddrugsnews. com Wider Health Series | DDN | 7