Hepatitis C Trust and HCV Action publish 'Reframing Reinfection' report

Reinfections may impact hepatitis C elimination goal

  • Feedback from clinicians and frontline workers in recent years has indicated that an increasing number of reinfections are being identified in the UK, with research in some parts of England documenting reinfection rates as high as 19% within two years.
  • Hepatitis C patients often face many health and care needs, from addiction to mental health to homelessness and these additional factors can indirectly raise reinfection rates as well as contribute toward immense suffering and unnecessarily shortened lives.
  • The Reframing Reinfection report sets out to understand what the NHS and frontline services working with people at risk of hepatitis C are seeing in relation to reinfection, what is already being done, and what more we might put in place locally and nationally to address this. 

 

HCV Action and The Hepatitis C Trust have published a joint report on hepatitis C reinfections, 'Reframing Reinfection: towards sustained hepatitis C elimination in the UK'.

As a disease that predominantly affects people who inject drugs, hepatitis C is a unique public health issue. It is a key driver of health inequalities but – when approached in the right way – treatment can result in greater engagement by individuals with public services and can be an important turning point in people’s lives.

Left untreated a chronic hepatitis C infection can lead to serious liver damage, in some cases necessitating complicated and expensive liver transplantation. Yet this disease is preventable and curable with easy-to-take and fast-acting medication. Despite this, around 50-70% of the 118,000 people across the UK who are currently infected are not aware they have the virus.

Hepatitis C reinfection is a new case of hepatitis C in a person who had a previous infection, where the previous infection may have been cured with medication, or resolved without treatment. Through a literature analysis, survey, focus groups and interviews, the 'Reframing Reinfection report found that the key issues identified at the root of reinfection reflect the most critical challenges faced by the UK hepatitis C elimination programme as a whole. These challenges include insufficient access to NSPs, a lack of regular and consistent testing, inadequate harm-reduction provision, and an absence of comprehensive data collection on reinfections.

The 'Reframing Reinfection: towards sustained hepatitis C elimination in the UK' report features specific, holistic recommendations tailored to tackle the reinfections, and to ensure that we achieve sustainable elimination by the UK’s goal of 2030. These recommendations focus on the following five key areas which need urgent work and development:

i.             Adopting better HCV prevention strategies, particularly within harm reduction services;

ii.            Making more of the opportunity that hepatitis C treatment brings, not solely to prevent hepatitis C reinfection but to ensure patients’ wider needs – mental health, other infectious diseases, housing and addictions – that may also need to be addressed;

iii.           Increasing testing, ensuring that we reach everyone who may have been at risk of HCV infection and to provide earlier diagnosis for those who may have a repeat infection

iv.           Supporting people not in services, and develop an understanding of how to engage and cater to those with complex needs; and

v.            Ensuring robust data is available to inform an evidence-based approach and understand progress as these programmes develop.

In 2016, the UK Government signed up to the WHO Global Health Sector Strategy (GHSS) on Viral Hepatitis, committing the UK to the elimination of hepatitis C (HCV) as a major public health threat by 2030. As a result, England and the UK devolved nations set about developing, resourcing and implementing elimination initiatives and programmes. The 'Reframing Reinfection' report looks to contribute to the national understanding of reinfections and support efforts to eliminate hepatitis C with tailored recommendations on how it might be more effectively addressed in future.

Rachel Halford, CEO of The Hepatitis C Trust said:

“As we move towards hepatitis C elimination, we must begin to think about this as a sustainable change in practice and not simply a transitory target to be briefly met.

“It is absolutely vital that services providing support to people who inject drugs are given enough resource to provide evidence-based harm reduction initiatives and holistic support to the people they serve.

“If they are not given this, we risk losing a historic window of opportunity to eliminate a disease that has affected some of the most vulnerable in our society for decades.”

 

Read the 'Reframing Reinfection: towards sustained hepatitis C elimination in the UK' full report HERE