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On September 13th at the Downtown Eastside Carnegie Centre, Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS, updated the audience about the massive ongoing international program for the elimination of hepatitis B and C (and other forms of viral hepatitis). The World Health Organization has called for Global Elimination of Viral Hepatitis by 2030 and Canada has “signed on” to this call and furthering its goals both internationally and here in Canada.
What does “elimination” actually mean? It does not mean total eradication from the face of the earth, at least yet. Instead, the 2030 Target for Viral Hepatitis (primarily HBV and HCV) is 90% Diagnosed, 80% Treated, and 65% Reduced Mortality (assuming approximately 1.4 million deaths per year in 2014)
This is the Vision: “A world where viral hepatitis transmission is stopped and everyone has access to safe, affordable, and effective treatment and care.”
How to Achieve this Target and Vision:
First, achieve the 2020 Target of 3 million HCV infections treated worldwide
At the same time, nations must “scale up” 6 key interventions to high coverage:
- Safe injection practices and safe blood
- Harm reduction for PWID
- Safer sex (including condom promotion)
- DAA-based HCV Rx (hepatitis C treatment)
- Hepatitis B vaccination
- Hepatitis B treatment
Montaner noted the following facts which are of particular interest to the prevention and treatment of hepatitis C in our province:
- Guidelines recommend pharmaceutical treatment (Rx) for ALL HCV+ individuals.
- Formerly challenging populations, including Persons Living with HIV/AIDS (PLWH) and Persons who Inject Drugs (PWID), can achieve comparable high cure rates.
- HCV treatment is no longer the domain of the specialists. (See slide)
- HCV treaters should offer harm reduction support.
- HCV “Treatment as Prevention” will decrease HCV morbidity, mortality, and transmission.
At the end Dr. Montaner summarized that ultimately, HCV elimination will only be possible with the full engagement, linkage (to care), and treatment of all affected populations.