Spain leads the fight against hepatitis C

With almost 170,000 patients treated and cured in Spain since 2015, Spain leads the fight against hepatitis C worldwide. Despite this, it is necessary to continue to make progress in eliminating this chronic viral infection, for which there is no vaccine, but there is a treatment. heal. “Ten years after the introduction of antiviral drugs (ADDs) that cure the disease, there are four deaths a week in our country attributed to hepatitis C-related causes that are avoidable because there is a treatment that cures it in almost 100% of cases . and this, if given early, can prevent the damage it causes to the liver over the years.”

explains Dr. Javier Garcia-SamaniegoCoordinator of the Alliance for the Elimination of Viral Hepatitis in Spain (AEHVE) and Head of the Department of Hepatology at the University Hospital of La Paz (HULP) in Madrid.

The key to these findings lies in late diagnosis, which occurs in a third of cases and means that pre-existing liver damage is not reversible in many cases, despite liver healing. . Given the prevalence of active infection in the general population, which the Ministry of Health estimated at 0.22% in 2018 and which AEHVE estimates will be around 0.1% today, cases that have yet to be diagnosed, treated and cured overall population, that is, people who contracted this infection two decades ago and do not know that they have it or were not treated at that time. To achieve cure of infection in these patients, recent efforts are needed to inform and raise awareness about hepatitis C and identify undetected infection by offering and administering a diagnostic test (simple blood test) to the entire population without prior notification. HCV antibody test, born between 1945 and 1975.

The WHO itself goes even further in its latest update of the global strategies needed to accelerate the elimination of hepatitis C in the world, recommending screening of the entire population at this age. “Each person diagnosed late (symptoms of hepatitis C are nonspecific and disease can take up to 20 years to manifest) will generate a large burden of disease. -cirrhosis and liver cancer, among other things- for the healthcare systemexplains Dr. Martha Casado, President of the Spanish Digestive Foundation (FEAD)for whom “Incorporating artificial intelligence and diagnostic strategies such as clustering or pooling samples, as Galicia is doing with excellent results, would make age-based screening in the general population entirely acceptable.” It is estimated that there are still 20,000 people living with hepatitis C in our country who are unaware that they have the infection.

But identifying undetected or missing cases in the general population is not the only problem. Another great challenge “perhaps the most difficult task”According to Dr. Casado, it is to actively seek cases among the most vulnerable groups, people who are far from the usual patterns of care and who can only be reached through decentralized resources and alternative strategies. “We, specialists, have been following this path for ten years with the support of NGOs and local organizations closest to these population groups.”

with microelimination strategies that bring diagnosis and treatment closer to these people.