Spain, the world leader in the fight against hepatitis C, continues to search for 20,000 Spaniards who do not know they have the infection.

Almost 170,000 patients treated and cured since 2015, Spain leads the fight against hepatitis C worldwide. The paradox is that a decade after the introduction of antiviral drugs (ADDs) that treat this disease, there are four preventable hepatitis C deaths in our country every week: there is a treatment it cures in almost 100% of cases and this, if given early, can prevent the damage that the infection causes to the liver over the years. In Spain, 20,000 people are unaware they have the infection.

He will explain it this Monday Dr. Javier Garcia-SamaniegoCoordinator of the Alliance for the Elimination of Viral Hepatitis in Spain (AEHVE) and Head of the Hepatology Department University Hospital of La Paz (HULP) in Madrid. The key to these findings is 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.

The remaining cases have yet to be diagnosed, treated and cured and are from people who contracted the infection two decades ago.

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 currently be around 0.1%, cases that have yet to be diagnosed, treated and cured, are in the general population, that is, people who contracted the infection two decades ago and did not know they had it or were not treated at the time.

last effort

To reach treatment of infection In these patients, doctors emphasize, “continued efforts to inform and educate about hepatitis C” and identify undetected infection are needed by offering and administering a diagnostic test (a simple blood test) to the entire population without first detecting HCV antibodies. test, born 1945-1975.

The World Health Organization (WHO) itself, the expert explains, went even further in its latest update of strategies. necessary global accelerate the elimination of hepatitis C worldwide by recommending screening for the general population at these ages.

liver cancer

“Every person diagnosed late (symptoms are non-specific and the disease can take up to 20 years to appear) will generate high burden of disease – liver cirrhosis and Cancer liver, including for the healthcare system,” explains Dr. Marta Casado, President of the Spanish Foundation for the Digestive System (FEAD), for which “the union of artificial intelligence and diagnostic strategies “Such as sample grouping or pooling, as Galicia is doing with excellent results, would make age-based screening in the general population quite acceptable. There are an estimated 20,000 people still living with hepatitis C in our country.” not knowing they have an infection.

But identifying undetected or missing cases in the general population is not the only problem. “The most difficult task,” according to the doctor, is to carry out actively searching for cases among the most vulnerable populationspeople who are located far from regular health care delivery patterns and 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 entities closest to that population,” he adds.

Antiviral drugs

Experts remind that hepatitis C is a serious health problem. public health due to its incidence, morbidity and mortality, and healthcare costs. Before the advent of direct-acting antivirals, it was the leading cause of end-stage liver disease and liver cancer in Western countries, and was the first indication for liver transplantation.

Causes of infection The most common of these are unsafe injection practices, improper sterilization of medical equipment, and pre-1990 blood and blood product transfusions. The hepatitis C virus can be transmitted through sexual contact, although it is less common. associated with practices such as “chemsex”.– and are transmitted from an infected mother to her child.