Are there national strategies, plans and guidelines for the treatment of hepatitis C in people who inject drugs? A survey of 33 European countries.

Mojca Maticic,Sergeja Gregorcic,Eberhard Schatz,Jeffrey V Lazarus,Jerneja Videcnik Zorman

doi:10.1186/1471-2334-14-s6-s14

Abstract

BackgroundHepatitis C virus (HCV) infection represents a major global health problem, which in high-income countries now mostly affects people who inject drugs (PWID). Many studies show that the treatment of HCV infection is as successful among PWID as among other populations and recently PWID have been included in the international guidelines for the treatment of HCV infection. The aim of this survey was to collect data from European countries on the existence of national strategies, action plans and clinical guidelines for HCV treatment in the general population and PWID in particular.MethodsThirty-three European countries were invited to participate. Data on available national strategies, action plans and guidelines for HCV treatment in general population and in PWID specifically were collected prospectively by means of a structured electronic questionnaire and analyzed accordingly.ResultsAll of the 33 invited European countries participated in the survey. Twenty-two responses came from non-governmental organizations, six from public health institutions, four from university institutions and one was an independent consultant. Fourteen (42.4%) of the countries reported having a national strategy and/or national action plan for HCV treatment, from which ten of them also reported having a national strategy and/or national action plan for treatment of HCV infection in PWID. Nearly three-quarters reported having national HCV treatment guidelines. PWID were included in the majority (66.7%) of the guidelines. Fourteen (42.4%) countries reported having separate guidelines for the treatment of HCV infection in PWID.ConclusionsGiven the high burden of HCV-related morbidity and mortality in PWID in Europe, the management of HCV infection should become a healthcare priority in all European countries, starting with developing or using already-existing national strategies, action plans and guidelines for this population.

Highlights

Hepatitis C virus (HCV) imposes a considerable disease burden worldwide and is one of the major underlying causes of chronic liver disease-related death [1]
In Slovenia, the proportion of people who inject drugs (PWID) treated for HCV increased from 3% to 13% in the first three years after the 2007 introduction of the national strategy, action plan and clinical guidelines; 72% of all the newly treated patients in the period 2008-2010 reported a history of drug use [64]
To the best of our knowledge this is the first study to present data on the existence of national strategies, action plans and guidelines on HCV treatment in 33 European countries, and to present data of this nature relating to PWID

Summary

Introduction

Hepatitis C virus (HCV) imposes a considerable disease burden worldwide and is one of the major underlying causes of chronic liver disease-related death [1]. It has been estimated that between 130 and 170 million people are chronically infected with HCV worldwide and that 350,000 deaths occur each year as a result of HCV [7]. Many studies show that the treatment of HCV infection is as successful among PWID as among other populations and recently PWID have been included in the international guidelines for the treatment of HCV infection The aim of this survey was to collect data from European countries on the existence of national strategies, action plans and clinical guidelines for HCV treatment in the general population and PWID in particular

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Results

Discussion

Conclusion