The European Liver Patients Association (ELPA), in collaboration with a European research team, recently launched the Hep-CORE study to assess national responses to viral hepatitis in the region, collecting a preliminary dataset in advance of World Hepatitis Day (28 July 2016). The data, which were obtained by surveying ELPA member groups, suggest that some European countries are falling short in terms of the policies and practices that public health experts and the World Health Organization recommend as the basis for an effective response to the hepatitis B virus (HBV) and hepatitis C virus (HCV) epidemics.
The study has enrolled one ELPA member group or coalition of groups from each country to complete a comprehensive survey on key aspects of the response to HBV and HCV in their countries. Survey topics include viral hepatitis policies, disease monitoring, prevention, testing and treatment.
The preliminary data have indicated that only 14 of the 23 countries represented in the initial analysis currently have national hepatitis strategies. A viral hepatitis resolution approved by the World Health Assembly in 2014 called on all countries to develop and implement national strategies for preventing, diagnosing and treating viral hepatitis.
Additionally, there appear to be gaps in relation to harm reduction services for people who inject drugs, a population with high levels of chronic HBV infection and HCV infection in most European settings. While 18 of the 23 countries represented by survey respondents were said to have opioid substitution therapy available in all parts of their respective countries, only 7 of the 23 were reported to have needle and syringe programmes available in all parts of their respective countries. Needle and syringe programmes are proven to be a key viral hepatitis prevention tool.
The study also found that a high proportion of European countries place restrictions on access to direct-acting antiviral treatment for hepatitis C if people have a history of injecting drug use, or are active drug users.
Preliminary evidence of long waiting times for referral to liver specialists in some of Europe’s wealthiest countries, including Austria, Sweden and the United Kingdom, was also found during the study. In the United Kingdom the average waiting time for referral from primary care to a liver specialist is now estimated at over 12 weeks, the longest waiting time reported in Europe.
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