SCOTLAND'S APPROACH TO FIGHTING HEPATITIS C

SCOTLAND'S APPROACH TO FIGHTING HEPATITIS C 

The Wall Street Journal has an in-depth article about how Scotland is taking an "aggressive" approach to fighting hepatitis C.

Unlike many countries, Scotland considers injection drug abusers for treatment and conducts widespread testing of injection drug users for the disease and offers them medication, the paper says.

In many other countries injection drug abusers are considered too unreliable to turn up for appointments or to stick to the costly treatment regimen lasting many months, according to the newspaper.

The country was a hit by a wave of hepatitis C in the 1980s and because the disease can take 20 years or so to begin to affect the liver, Scotland is only just beginning to see the increase in end-stage liver disease, according to the article.

Scotland's 100 million pound programme started in 2008 and ends in 2015 and diagnoses and treats anyone with hepatitis C, regardless of their history, even though medication can cost between $10,000 and $40,000 per patient, the WSJ reports.

About half of the 38,000 Scots estimated to have been chronically infected have now been diagnosed, compared with 39% in 2007.

Of those around 1,100 new patients a year are receiving treatment, nearly triple the number from 2007 with the aim is to reach 2,000 new patients a year, which should prevent up to 5,200 cases of liver cirrhosis by 2030, according to the article.

The article also quotes research by Dundee University, comparing outcomes in hepatitis C patients who never injected drugs with outcomes in injection drug using patients.

Results from 291 patients found 61% of non-injection drug abusers achieved sustained virologic response, compared with 55% of former users and 47% of active users.

Authors concluded that active injection drug use "is not a barrier to treatment or a successful achievement of SVR," the WSJ points out.

The Scottish approach is also being trialled in California, the article reports, although in the US a lack of medical insurance among many drug users makes tackling the disease harder, according to the newspaper.

Source
WSJ Article