The project aims to bring down rates of hepatitis C infection among a population where it has been a significant and entrenched problem, with consequent impacts on public health and financial cost to the NHS.
It is hoped that by giving early treatment to small numbers of people who inject drugs and are infected with hepatitis C, it will prevent the need to treat larger numbers later. This will help reduce instances of liver cirrhosis and cancer, which can develop over time if hepatitis C is not treated.
The £2.2 million project is funded by the Scottish Government and the companies Janssen and Roche.
“Hepatitis C is a disease which consumes a significant amount of resource in the NHS,” said Dr John Dillon, Clinical Senior Lecturer and Consultant Hepatologist, who is leading the project.
“The general thinking in recent times has been that the population of people who inject drugs is generally too unstable and consists of people with lives which are too chaotic to allow for the sort of sustained treatment that Hepatitis C needs to achieve a cure.
“However, our view is that with the right approach, supported with appropriate resources, we can tackle what is a very significant problem and reduce the rates of hepatitis C infection.”
Minister for Public Health Michael Matheson said, “In Scotland, we are recognised internationally for our response to hepatitis C, which is in large part due to the Scottish Government’s Hepatitis C Action Plan and Sexual Health and Blood Borne Virus Framework.
“This project demonstrates our commitment to invest in new approaches and efforts to tackle the disease. The work being carried out by the clinicians and academics in Dundee will undoubtedly be of international interest, and could significantly change the way we respond to the disease.”
Hepatitis C has been a particular problem among people who inject drugs as it can be easily spread through contact with blood, so shared drug paraphernalia such as needles present a significant risk.
Ann Eriksen, NHS Tayside’s Executive Lead for sexual health and blood-borne virus, welcomed the trial and said, “The clinical trial offers for the first time the real prospect of radically reducing the prevalence of hepatitis C in the population most at risk. The fact that this has come to Tayside is testament to Scotland’s success in tackling hepatitis C as a country and in particular to the farsightedness, innovation, skill and care of the clinical team and partner agencies.”
Dr Dillon and colleagues hope to recruit 100 patients with hepatitis C over the next five years. They will be enrolled in a programme of treatment delivered through existing frontline specialist services. Patients will be supported in a variety of ways including mobile phone reminders to take their medication.
“The course of treatment for hepatitis C is a long one, running for 24 weeks or more, and it requires patients to take their medication regularly and attend for an injection once a week,” said Dr Dillon. “It is a treatment that requires support and dedication but we think that, done properly, it could have a marked effect on infection rates and, consequently, significant benefits in terms of public health and cost to the health services.”
Hepatitis C is a virus that is carried in the blood and predominantly affects the liver; it is sometimes called HCV or hep C. It can cause inflammation, scarring and sometimes significant cirrhosis damage to the liver. Cirrhosis increases the risk of developing liver cancer and can even lead to liver failure.
About twenty per cent of people living with hep C will fight off the infection without treatment and, as a result, it will be naturally cleared from their bodies leaving no long-term effects.
However, for most people who have hep C it is a chronic condition which means that it can cause liver damage for a long period of time often over 20-30 years. It can be present for many years without any symptoms at all. The first time that a patient may know they have the infection is when they develop liver failure or liver cancer.
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