Monday 8 December 2014

'We can eliminate Hepatitis C within our lifetimes', say European experts at inaugural Five Nations conference on HIV and Hepatitis

Meeting in London for the first Five Nations Conference on HIV and Hepatitis, Europe's leading hepatitis experts will today call for a global effort to eliminate Hepatitis C (HCV), which affects an estimated 170 million people worldwide, including around 0.5% of the UK population.

Among ten issues addressed in a landmark statement by clinicians from France, Germany, Italy, Spain and the UK, together with their community partners the European AIDS Treatment Group, is an appeal to governments, the pharmaceutical industry and the medical profession to co-operate in making the latest generation of effective antiviral treatments for Hepatitis C affordable and accessible to all patients.

The group also calls on world leaders to use lessons learned from HIV and AIDS as a model for raising awareness of HCV; testing for the infection; and building on the existing HIV treatment infrastructure to reduce the number of deaths from HCV-related end stage liver disease and liver cancer. With new antiviral treatments for HCV working well both for patients with and without HIV, European experts are also calling for people with HIV to receive these treatments as a priority.

Dr Ranjababu Kulasegaram, Chair of the British HIV Association Hepatitis Society Subcommittee, said: "On the 25th anniversary of the discovery of HCV, we have reached a turning point in our ability to treat the infection, with revolutionary new drugs that offer real hope of eradicating this pernicious, often hidden disease. Despite their effectiveness, however, these treatments will have little value for the majority of people with HCV, unless their costs are drastically reduced and they are made universally accessible."

Dr Mark Nelson, Chair of the Five Nations conference programme, said: "We know preventing transmission of the infection is possible, through a range of measures including needle exchange and opiate substitution therapy programmes for people who inject drugs and education campaigns to prevent sexual transmission, particularly among men who have sex with men. We strongly urge governments, the pharmaceutical industry, clinicians, community organisations and non-governmental organisations to work together to make global elimination of HCV a realistic target within our lifetimes."

The Five Nations Conference on HIV and Hepatitis takes place from 8-9 December 2014 at the Queen Elizabeth II Conference Centre in London, as an opportunity for Europe's leading hepatitis and HIV experts to share research and discuss priorities for research, treatment and care to meet the global challenge of viral hepatitis and liver disease in the context of HIV disease.

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Notes for editors
The Five Nations Conference statement in full:

The organising committee, together with our academic partners and the European AIDS Treatment Group, have had the privilege to present the first Five Nations Conference on HIV and Hepatitis.

The programme brought together clinicians, academics and the civil society to discuss aspects of liver disease in those living with HIV-infection.

We would like to highlight a number of pertinent issues which have become clearer and a ‘call to action’ to facilitate and improve therapy in the HIV population.

1. Liver disease remains an important cause of morbidity and mortality in HIV-infected patients. We reiterate the importance of viral hepatitis, but also highlight emerging issues of drug-induced liver toxicity, alcohol and non-alcoholic fatty liver disease, which are important contributors to liver damage in our patients.

2. Transmission of viral hepatitis infection is preventable. In keeping with national and International guidelines we strongly support a concerted effort to ensure appropriate and increased testing for viral hepatitis infection, vaccination programmes for Hepatitis A and B, coupled with measures to prevent mother-to-child transmission of viral hepatitis.

3. Needle exchange programmes and opiate substitution therapy programmes for intravenous drug using populations together with education campaigns to prevent sexual/club-drug associated transmission of HCV amongst men who have sex with men should be prioritised across Europe.

4. Research efforts need to identify networks of HCV infection and strategies to eliminate HCV transmission.

5. Hepatitis B is treatable and steps must be made towards early identification and evaluation of chronic HBV infection so that appropriate antiviral therapy and adequate management and follow-up are instituted.

6. Delta virus co-infection causes significant liver disease in substantial number of HBV-infected patients. This should be identified early and further research is needed to identify optimum treatment modalities.

7. A number of directly acting antiviral (DAA) agents have been licensed or are about to be licensed for the treatment of HCV. Interferon-free and ribavirin-free therapy has become the standard of care in many guidelines and populations. HIV-infected patients respond at least as well to these therapies, and remain an ‘urgent need’ population (due to faster rates of progression and associated comorbidities) and should be prioritised for access to DAA-based therapy across Europe.

8. We urge the pharmaceutical industry and the licensing authorities to ensure that drug-drug interaction data is made available early so that there is no delay in therapy becoming available to HIV co-infected populations.

9. Governments, the pharmaceutical industry, clinicians and the civil society must work together so that affordable and timely DAA-based therapy is made available to all.

10. We must use the experience of the global rollout of anti-HIV therapy and the infrastructure and clinical platforms for HIV testing and care to ensure global testing for HCV and rollout of DAA-based HCV therapy. Global elimination of HCV is a realistic target that needs a global response.

About BHIVA
Founded in 1995, BHIVA is a well-established organisation which is committed to providing excellence in the care of those living with and affected by HIV. It acts as a national advisory body to professions and other organisations on all aspects of HIV care. BHIVA also provides a national platform for HIV care and contributes representatives for international, national and local committees dealing with HIV care. In addition, BHIVA works to promote undergraduate, postgraduate and continuing medical education within HIV care. Visit www.bhiva.org for more information about BHIVA, and follow us on Twitter @BritishHIVAssoc

About the Five Nations Conference
The conference is organised by BHIVA with academic support from the French National Agency for AIDS and Hepatitis Research (ANRS), German AIDS Society (DAIG), Hepatitis Research Group, Spanish Society of Infectious Diseases and Clinical Microbiology (GEHEP), Italian Society of Infectious Diseases and Tropical Medicine (SIMIT), British Association for the Study of the Liver (BASL), British Viral Hepatitis Group (BVHG) and the European AIDS Treatment Group (EATG).