“Without the pandemic, in 2021 we would have reached our goal.” Javier García-Samaniego, Coordinator of the Spanish Alliance to Eliminate Viral Hepatitis (AEHVE) and Director of the Liver Unit at HU La Paz, Madrid confirmed this. The expert has no doubts that Spain is “one step away from historic health successes and the inclusion of hepatitis C in the rare disease category due to its low prevalence”.
García-Samanigo made the statements on the occasion of World Day against Viral Hepatitis, assuring that Spain is currently “the country in the world that has reason to celebrate, especially when it comes to hepatitis C”. In fact, according to the data forecast for 2020, before the outbreak of the epidemic, the Polaris Observatory (including experts from all over the world, including Spain) already believed that Spain was the only country in the world that could meet this requirement. All targets Elimination by 2021: 90% reduction in new infections; 65% reduction in deaths from cirrhosis and liver cancer; over 90% diagnosis; and treatment for at least 80% of those who require it.
The reasons for this optimism stem from lessons learned on the one hand in the management of Covid-19 diagnoses, and on the other hand in the #HepCityFree programme, through which local Spanish businesses contribute to the elimination of Hepatitis C, especially in vulnerable in the group. Regarding the first point, the AEHVE coordinator referred to the experience being developed in Galicia, a worldwide pioneer in the diagnostic analysis of hepatitis C virus (HCV) by pooling samples (PCR), also known as pooling, Has excellent performance. Healthy results and huge savings. Dr. García-Samaniego explained: “This innovation is important because it greatly reduces the possibility of expanding opportunistic screening strategies by age, such as those that professionals have been asking for for many years.”
Currently, apart from Galicia, only a few autonomous regions, such as Cantabria and Andalusia, consider opportunistic screening by age, which is also considered by the president of the Spanish Association for the Study of the Liver (AEEH), a university professor of medicine According to the hepatologists of Seville and HU Virgen del Rocío, “the lower cost of co-diagnosis could be a way of extending it to more communities, and the Ministry of Health could include it in its proposal document, which The document does not now consider screening the general population by age, but limits it to risk factors”. “Spain is very close to eradicating hepatitis C. We still have about 20,000 people who need treatment and cures. The latest seroprevalence survey (2018) data from the Ministry of Health shows an active infection rate of 0.22%. We think this rate is even lower , close to 0.1% of the general population. So we are very close, just one more step towards diagnosing cases that are still hidden and we can get there,” affirmed the chairman of the AEEH.
In addition to screening the general population, another challenge is that vulnerable populations, particularly the homeless, intravenous drug users, and men who have sex with men, are a major source of active infection. Important steps in this direction have also been taken in recent years through the commitment and collaboration of cities addressing these challenges, and are tested in AEHVE’s #HepCityFree programme. For Hepatologist Manuel Romero, president of the Spanish Association for the Study of the Liver (AEEH) and coordinator of the local #HepCityFree committee in Seville, “Local communities are in the fight to eliminate this disease The key role that can be played has already been demonstrated. Hepatitis C, especially through the screening of the most vulnerable populations, through which Seville has become an international city of reference in this field, thanks to the local government with the regional authorities model collaboration with NGOs working in this field”.
As Galicia has begun to expand age-based opportunistic screening across Spain and has municipalities aggressively seek cases in populations that would not normally have access to the health system, both AEHVE and AEEH believe the forecast is “very reasonable” for this public health The problem will be gone by 2024 or 2025. “The Spanish health system’s approach to hepatitis C will be a successful ending”, affirms Manuel Romero, while García-Samaniego agrees: “As a country we once again revolve around our The public health system has come together to achieve great success, and despite its flaws, it still gives us reason to be proud. “
viral hepatitis campaign
However, our country is still far from the hepatitis B elimination goal set by the World Health Organization, and the Polaris Observatory predicts that it will not be achieved before 2051. Accurate reporting of all viral hepatitis (A, B, C, D), AEEHVE and AEEH have joined a campaign driven by the National Federation of Liver Transplant Patients FNETH and NGO Apoyo Positivo, supported by Gilead and AbbVie Experimental Room Sponsorship, which will take place tomorrow (Friday 28 July). Spain’s main train stations will issue a welcome greeting to all travelers so that they can enjoy their holidays without forgetting to protect their health from viral hepatitis.
The campaign will remind all travelers that hepatitis is “an infection that causes inflammation of the liver, which can cause damage” and that “the most common and important are viral hepatitis: hepatitis A, hepatitis B and CYD”. Regarding hepatitis A, he will point out that “it is associated with contaminated food and water, or poor hygiene and certain sexual practices”, while hepatitis B is “easily transmitted through sexual contact” with blood and may cause chronic disease, cirrhosis and/or liver cancer. In addition, “most adults who become infected with hepatitis B recover fully, but if the infection becomes chronic, there is no cure.” Regarding hepatitis C, he will report, it is “an asymptomatic infection until the liver damage begins to cause symptoms, such as cirrhosis and liver cancer,” and that “early detection is critical to accessing treatment that cures the infection.” Finally, remember that “hepatitis D virus is a satellite virus that requires B Hepatitis virus cannot replicate in the body”, and “depending on how the co-infection occurs, it may cause liver damage”.
Likewise, the campaign will have a particular impact on prevention, emphasizing the importance of practicing “good hygiene, washing hands, washing food, or avoiding contact with feces or blood in the absence of preventive physical barriers, such as during certain sexual practices.” or sexual activity”. clinic” and “avoid injecting drugs or minimize risk of exposure, and never share consumable materials or paraphernalia.” Likewise, it recommends “diagnosis or rapid testing to reassure” and, if positive, “treatment and possible cure.” ways to prevent new infections” and emphasized the importance of vaccination against hepatitis A and B. To date there is no drug for hepatitis D, the campaign’s sponsors emphasized, European Medicines Agency A drug was approved in 2020, but it has not yet been funded in Spain, despite the fact that 5,000 to 7,000 patients in Spain suffer from the disease.