Hepatitis C strategy in Scotland
Sharon Hutchinson, David Goldberg, Gareth Brown, Nicola Rowan, John Dillon, Avril Taylor and Syed Ahmed
pp 1-4
In June 2004, Scotland’s Health Minister recognised that hepatitis C virus was one of the country’s most challenging public health concerns.This acknowledgement came shortly after a Royal College of Physicians of Edinburgh Consensus Conference on Hepatitis C, which highlighted that ‘services are already struggling to cope with the burden of infection,’ and that ‘significant resources must urgently be directed at improving prevention and delivery of care’. Following an extensive consultation, the Health Minister and the Chief Medical Officer launched the Hepatitis C Action Plan for Scotland in September 2006.
|
Comment: Strategic and immune responses
Alastair Miller
pp 3-3
There are, indisputably, certain aspects of the Scottish healthcare system that are envied by those of us practicing south of the border. The Scottish Government launched the Hepatitis C Action Plan for Scotland in September 2006, with the aims of preventing, diagnosing and treating HCV. There was a specific focus on people who inject drugs. Sharon Hutchinson and colleagues give us an insight into the development, implementation and outcomes of this plan, although they do not discuss how it will cope in the face of the rapidly expanding availability, and cost, of the new direct-acting antiviral agents. Anecdotally, colleagues in Scotland seem to be experiencing less difficulty in accessing protease inhibitors, and this may be as a result of the Scottish plan.
|
Immune responses in hepatitis B: a brief overview
Mala K Maini, Nicholas Easom, Dimitra Peppa and Abhishek Das
pp 5-7
Chronic hepatitis B virus infection currently affects more than 350 million people worldwide. Despite the availability of a preventive vaccine, the burden of liver disease carried by those who have chronic infection poses a significant global health threat. Available antiviral regimens are suboptimal; they are expensive, rarely curative and prone to resistance. The observation that the vast majority of adults who are acutely infected go on to control the virus suggests that immunotherapeutic approaches could be utilised synergistically with available drug regimens in chronic infection, to tip the balance in favour of viral clearance. Here, we summarise what is known, and what remains to be elucidated, before this becomes a possibility.
|
Practical difficulties in treating hepatitis C patients in prison
Catriona Sykes, Karen Robertson and Nicholas Kennedy
pp 8-10
Chronic viral hepatitis, particularly chronic hepatitis C virus (HCV), is common in incarcerated individuals. In the USA, 1–3.7% of prisoners tested had chronic hepatitis B virus and 23–34% had chronic HCV. In a UK study, 24.2% of prisoners tested were anti-HCV antibody-positive and 13.9% anti-hepatitis B core antibody-positive. Around one third of the total HCV-infected population in the USA is estimated to pass through the penal system each year.
|
How would you deal with this patient?
Patrick Kennedy
pp 10-10
A 29-year-old female is infected with hepatitis C –this was probably transmitted following a blood transfusion at the age of nine. She has had abnormal liver function tests for some time and has been formally investigated in the clinic, with the following results.
|
The British Viral Hepatitis Group: the other hepatitis viruses
Geoffrey Bowden
pp 11-11
While much attention is paid to hepatitis B virus and hepatitis C virus genotype 1, there are, of course, other viruses that cause hepatitis. On 13 July 2012, a British Viral Hepatitis Group meeting in Birmingham focused on some of these.
|