The Malta Independent 23 July 2019, Tuesday

14 million EU citizens living with Hepatitis C; low figures for Malta

Kevin Schembri Orland Sunday, 30 August 2015, 09:00 Last update: about 5 years ago

There are currently around 13.3 million Europeans living with hepatitis B and 14 million living with hepatitis C, MEP Miriam Dalli pointed out in a question posed to the European Parliament.

“Approximately 120,000 people in Europe every year die because of these diseases.”

In Malta, the number of cases did not seem high in 2013, with 3.3 people per 100,000 being reported as having been infected that year. The number in other states is considerably higher such as in the UK, where the number stood at 21.5 per 100,000 people (nearly 14,000 in total that year).

The MEP explained that over the past four decades there has been a considerable increase in the number of Europeans affected by hepatitis B and C. 

The Commission said it had recently issued a call for proposals for projects on the early diagnosis and treatment of viral hepatitis, and that it is preparing a joint action with EU member states, focusing on harm-reduction measures amongst people who inject drugs, where hepatitis is also targeted.

In addition, the European Monitoring Centre for Drugs and Drug Addictions (EMCDDA) recently published a special report on hepatitis C virus (HCV) treatment in respect of injecting drug users.

The Centre describes Hepatitis C as the most common infectious disease in people who inject drugs, amongst whom it is usually transmitted through the sharing of injecting equipment such as needles and syringes. “Most of those who become infected go on to develop chronic HCV infection, which can lead to severe health problems in individuals and place a major burden on health care systems. Yet hepatitis C is both preventable and curable and the development of new medicines to treat the disease has made rapid progress, with several new medications being given marketing authorisation in 2014 and 2015”.

Infected individuals often do not show any noticeable symptoms, the Centre explained, “and many are unaware that they are carrying the virus, leading to it being referred to as a ‘hidden’ epidemic.

“Recent advances in hepatitis C treatment approaches, including the development of new molecules called direct-acting antivirals (DAA) and the introduction of interferon-free treatment regimens, show much promise, including the potential for treating hepatitis C among people who inject drugs. In this area, modelling studies suggest that hepatitis C treatment could play an important role in preventing the spread of the virus”.

Despite this, however, treatment uptake remains low among injecting drug users. “Service providers cite concerns around adherence, risk of exacerbation of psychiatric disorders and the potential for re-infection after treatment as reasons for not assessing or treating hepatitis C in injecting drug users”.

The EMCDDA said that the if hepatitis C treatments for people who inject drugs are to be effective, they will need to be embedded in and delivered as part of a comprehensive package of interventions. “An important area for future investigation will be to review the uptake of hepatitis C treatment among people who inject drugs, and identify and challenge any barriers that prevent them from receiving an adequate and equitable service”.

In an interview with this newspaper last December, published in the lead-up to the l-Istrina fund-raiser in aid of the Malta Community Chest Fund, President Marie Louise Coleiro Preca had remarked that a cure for hepatitis C, with a 90 per cent chance of recovery, had been found – but that treatment costs per patient were between €50,000 and €100,000.

The President had added: “The fact of the matter is that, on average, €230,000 is required each and every month [by the MCCF for specialised treatments]. €200,000 is spent on specialised chemotherapy or medication such as that for the treatment of Hepatitis C. If that amount grows, as it seems it will – according to oncologists’ forecasts, we will need to collect even more than ever to save lives and give people a better quality of life when they are suffering.”

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