Eliminating hepatitis C requires interdisciplinary work to identify hidden cases

Since launch ‘Hepatitis C Strategic Plan(HCV) have been reported in Spain cured more than 165,731 patients with a cure rate of around 95%, which demonstrates the efforts made to change the lives of these patients and position our country as a benchmark in this field. In fact, Spain could become one of the first countries in the world to eliminate hepatitis C.

However, to achieve the WHO goal To eliminate viral hepatitis by 2030, initiatives must be launched to improve prevention, early diagnosiscomprehensive treatment and management of patients with hepatitis C, as emphasized during the “Workshop on Viral Hepatitis: Elimination and Control as Key Goals” organized by Gilead and in which decision-makers from major scientific societies participated in its approach.

Experts agreed that this is necessary. take advantage of all screening and diagnostic options and go where patients might be. In this sense, they emphasized the importance of carrying out diagnostic tests among those people or groups who represent risk indicators and may be carriers of this virus.

Manuel Romero, President of the Spanish Association for the Study of the Liver (AEEH), spoke about the current situation with viral hepatitis in Spain, analyzing where we are and remembering that in order to eliminate hepatitis C and achieve the 2030 targets they must “scientific societies work interdisciplinary such as government administrations, professionals and organizations. To do this we must encourage comprehensive and opportunistic diagnostics

to help thousands of patients with viral hepatitis in Spain waiting to be identified, connected to the healthcare system and treated.”

Radical changes in 10 years

Romero recalled that over the past ten years, “the scenario has changed radically” regarding this disease thanks to emergence of direct-acting antiviral drugswhich represents a paradigm shift regarding hepatitis C. Another turning point occurred in 2017 when moving towards the goal of eradicating the disease, thereby promoting universal access to these treatments for patients regardless of the extent of their disease. This is now a key point for the AEEH President. fight other hepatitis such as B (HBV) and Delta (HDV), for whom its diagnosis is important. In this regard, he recalled that hepatitis Delta can quickly, within five years, develop into cirrhosis of the liver or hepatocellular carcinoma.

Diagnosis of viral hepatitis and the search for opportunities were discussed at the seminar Federico GarciaPresident of the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc), who recalled the importance of diagnosis: “Very important use any analysis to diagnose them and treat them, a comprehensive diagnosis of viral hepatitis is carried out in less than 50% of cases for HBV/HDV. This is why it is critical to increase the number of people who are diagnosed and seek treatment. simplify and improve the care regimen to avoid incomplete diagnosis and loss of patients (recovery of the lost). For hepatitis Delta, we must test all people with chronic hepatitis B for HDV and treat them to prevent progression of the disease.”

Garcia explained that There are many “lost patients” in the system who were diagnosed a long time ago, but were not treated. According to him, up to 15 thousand patients could find themselves in such a situation, so he advocated working to bring them closer to consultations to determine the need for treatment. In addition, this expert stated that, according to the literature, there are health centers where hepatitis prevalence is highest

so he raised the possibility of working on them. If the prevalence in patients presenting in primary care is 0.22%, then in emergency departments it is multiplied by two or three until it reaches 0.7%. In other areas, such as mental health centers, this figure is multiplied by four, and in addiction centers it is 55 times higher.

Detection in an emergency hospital

Despite this, it remains opportunities to bring diagnostics closer to those people who live with the infection and do not know about it. Examples are hospital emergency service, where the prevalence of active infection is three times higher than in the general population. So, Juan Gonzalez del CastilloCoordinator of the Semes Infection Working Group (INFURG-Semes), explained that emergency services play a key role in achieving zero hepatitis goals because “44% of patients seen in the emergency department do not know their infection status.At the same time, patients with a pronounced degree of fibrosis are often identified (up to 51%). Late diagnosis can lead to progression to severe disease associated with higher mortality, poorer quality of life and higher costs.”

Many of the viremic patients treated in emergency departments represent populations that are difficult for the healthcare system to access. In most cases, this route becomes the only entry point. For this reason, González del Castillo recalls that “ Opportunistic diagnosis in emergency services is key to eliminating, having achieved automation of the diagnostics carried out on them. Therefore, the participation and collaboration of different scientific societies is essential to achieve HCV elimination in Spain.”

All experts have spoken use digital tools for automation the patient provides as much information as possible to the experts, as well as a request for screening tests for patients for whom it is indicated and has their approval.

During the presentation, Martha Velasquez, Director of Gilead’s Liver Business Unit, recalled that Gilead has more than 20 years of experience in the fight against liver diseases and more than 10 achievements towards a promising future. During this time the company reached improve the lives of more than 10.9 million people

around the world, always striving to make a difference in the lives of millions of people and their families, through strong commitment to eliminating hepatitis C and improve control of HBV and HDV.

Gilead has played and continues to play a fundamental role in changing the course of HCV and will continue to work with all parties involved until its eradication is achieved through initiatives that ensure all patients are diagnosed and treated. The company has completed two decades of innovation in the field of viral hepatitis since it began its journey with the first treatment for hepatitis B in 2003. Since 2014, Gilead has a portfolio of antiviral drugs for the treatment and treatment of hepatitis C. This portfolio of drugs for the treatment of viral hepatitis hepatitis was expanded in 2024 to include the only approved treatment for HDV on the National Health System (SNS). in Europe.