HSE's national strategy for hepatitis C to be published


Updated document set to be launched after two-year delay

THE HEALTH Service Executive (HSE) will launch its long-awaited national hepatitis C strategy today.

The working group tasked with developing the strategy was created in 2007 and there were fears it would never be published given that it was finished more than two years ago, and the HSE is in dire financial straits.

A hepatitis C strategy, prepared by the former Eastern Regional Health Area Board in 2004, was never published or significantly implemented.

However, the updated national strategy has finally been approved for publication and contains 36 practical recommendations across four key areas – surveillance; education, prevention and communication; screening and laboratory testing; and treatment.

One of the key recommendations of the strategy is the establishment of a national hepatitis C register and improved surveillance and data collection to better determine its causes and the treatment progress of patients.

It also recommends that GPs, particularly those working in addiction services, take on more of the care of hepatitis C patients, and that better education and prevention initiatives are implemented.

As the disease often has no symptoms many people remain undiagnosed, but it is estimated that 20,000 to 50,000 people in Ireland are infected. There were 9,282 cases of hepatitis C notified in Ireland between 2004 and 2010.

Chronic infection occurs in 70-80 per cent of adults acutely infected, where symptoms include joint pains, abdominal pain, loss of appetite, altered bowel habit, mood swings and insomnia. Complications of chronic hepatitis C include cirrhosis, liver failure and liver cancer. However, treatment advances in recent years are significantly improving outcomes.

About 80 per cent of hepatitis C infections in Ireland are caused by intravenous drug use, while the receipt of contaminated blood and blood products in the 1990s, in one of Ireland’s biggest healthcare scandals, resulted in about 1,700 people becoming infected.

The strategy’s key author, Prof Joe Barry, head of the department of public health and primary care at Trinity College Dublin, welcomed its publication and said its implementation would benefit services for hepatitis C patients.

While acknowledging the HSE’s deteriorating financial situation, he pointed out that many of the strategy’s recommendations were budget neutral.

The HSE said it was committed to its implementation “on a phased, prioritised basis, with due regard to the current employment and resource constraints”. The strategy has a phased target of the end of 2014 to fully implement all its recommendations.

The Irish Times reported last month that the HSE had made hepatitis C drugs Boceprevir and Telaprevir available to public patients, following the intervention of the Department of Health. The two drugs will cost the HSE €30 million a year.