Spain at the forefront of hepatitis C eradication

This Sunday, July 28, was World Hepatitis Day, a date that highlights Spain’s leadership in eliminating hepatitis C, in line with the World Health Organization (WHO) targets for 2030.

Thanks to the coordinated efforts of the health care system, public health organizations, and advances in treatment, we are close to eliminating it, with significant progress. Some of these, as Fran Franco Alvarez de Luna, a spokesperson for SEIMC, notes, “are the inclusion of a comprehensive diagnostic for chronic hepatitis in a single analytical extract; and one-step diagnostic strategies for the detection of antibodies and HCV RNA or reflex diagnostics for hepatitis Delta in patients with hepatitis B. However, much remains to be done, as there are other persistent challenges associated with hepatitis B and D.

HEPATITIS C

Over the past decade, Spain has implemented effective detection and treatment programmes for hepatitis C, allowing it to gain a prominent place worldwide. The introduction of direct-acting antiviral drugs has transformed treatment, allowing a cure in most cases. Access to these treatments, combined with awareness and screening campaigns, is critical to reducing the prevalence of the disease in the population.

However, as the coordinator of the Alliance to Eliminate Viral Hepatitis in Spain (AEHVE), Javier García-Samaniego, recalls, “considering that 188 deaths occur every year in Spain due to causes related to hepatitis C, we cannot be satisfied. Almost 10% of road deaths occur, and like these, they are preventable and avoidable.

There is still a long way to go, since the number of people with undetected active hepatitis C in Spain is estimated at 15,856, and with active hepatitis C at 54,676, leaving only about 70,532 people to be diagnosed. first, and then try in our country. On top of that, there are the other problems we have to face with viral hepatitis.

HEPATITIS B and D

Despite advances in the fight against hepatitis C, HBV remains a serious problem. Vaccination is effective in preventing new infections, but management of chronic cases requires ongoing care and access to appropriate treatments.

Added to this is hepatitis D, which, although less well known, is particularly worrisome because of its complexity. The virus can only infect people who already have HBV, making the disease more severe and difficult to treat. Hepatitis D can lead to more rapid progression to cirrhosis, liver cancer, and even death.

But, as SEIMC’s Franco Alvarez de Luna points out, “in terms of treatment advances, the only treatment approved in Europe for hepatitis Delta was recently included in the National Health System, representing “a significant step forward in the treatment of the most aggressive and serious form of viral hepatitis.”

EARLY SCREENING AND DIAGNOSIS

Screening and early diagnosis are essential for effective control of viral hepatitis. Early detection of carriers of the virus allows treatment to be initiated before the disease progresses to more serious stages. It is therefore essential to implement systematic and accessible screening programs, especially for high-risk groups, to identify needs and barriers to hepatitis C elimination in various health care settings, and to mobilize all involved agents to activate new strategies.

To this end, as Dr. Manuel Romero, President of AEEH, recalls, “The National Liver Health Plan, which was recently presented, defines 6 areas of work, one of which is viral hepatitis, with the elimination of hepatitis C as one of its main objectives.”

“Hepatitis C is a paradigm in the history of medicine. There is nothing like it because this virus was discovered in the late 80s and became the main cause of liver disease in the West, cirrhosis, indications for transplantation and liver cancer. In these 35 years, we have managed to turn the tide and we are on the verge of eliminating the disease. There is no similar example in any other field of medicine,” says Dr. Romero.

It is worth noting that the cure of hepatitis C has allowed an 84% reduction in the number of liver transplants and, consequently, their many consequences for patients, ranging from “organ rejection or infections to changes in quality of life due to changes in habits and continued medication,” FNETH points out.

But the problems with B and D remain, so Spain is making significant efforts to improve access to diagnostic tests and raise awareness of these diseases. Collaboration between health facilities, communities and health workers is vital to ensure that people are aware of their health status and can receive the necessary treatment in time.

Thus, on World Hepatitis Day, it is vital to recognize the achievements made in eliminating hepatitis C and the challenges faced by viral hepatitis B and D. Only with a focus on screening and early diagnosis and a continued commitment to innovation can we move towards a future without viral hepatitis.