Efforts Stepped Up to Eliminate Hepatitis C

The fight against blood borne viruses (BBVs) is being stepped up in Forth Valley with the appointment of a specialist community nurse and increased outreach services, including visits to Salvation Army premises and homeless units.

The drive is part of a national effort to meet the Scottish Government’s target of elimination Hepatitis C by 2024/2025.

Around 3,000 people in the area are believed to be infected with Hepatitis C – known as the silent disease – but so far only around 1,500 have been diagnosed.

Sheree Fowler, NHS Forth Valley’s newly appointed community blood borne virus nurse explained that post-pandemic the numbers coming forward for testing has dropped off significantly. She said: “This is a Scottish wide issue not just affecting Forth Valley. Worryingly there is also evidence of equipment sharing. The service has worked extremely hard in the last six years to encourage new equipment for each injecting episode. Unfortunately, lockdown has had a hugely negative impact on this particular activity. Harm reduction is paramount in preventing the onward spread of Hepatitis C, so we will therefore be reinvigorating our messages around injecting and avoiding sharing equipment.”

Carol Crawford, from NHS Forth Valley’s Blood Borne Virus Managed Care Network, added: “Our decision to get in touch with places such as the Salvation Army has been prompted because these are premises largely visited by men, and it is men who are generally more reluctant to engage with health services. New antiviral treatments for Hepatitis C, some of which have only become available recently, are proving very successful with a success rate of 97% for Forth Valley patients.

“Health experts agree these drug combinations are more effective with a 90-95% cure rate compared with 70-75% cure for traditional treatment for those with more advanced liver disease. They have fewer side effects and are taken for a shorter period, 8 to 12 weeks compared with up to one year. These new treatments also come in tablet form and one pill per day is all that’s required compared to the previous treatments which involved injections over a 12-month period with many side effects.”

Peer support has been identified as crucial in engaging client groups who don’t routinely access mainstream services such as GP practices and hospital appointments. The service already has a full-time peer support worker who has been very successful in encouraging and advocating for marginalised groups and plans are in place to have an additional three peer workers in the next couple of months. They will target Salvation Army soup kitchens, sex workers and homeless units, building relationships, trust and engagement with testing and treatment services in the community to avoid the need for people to travel to hospital appointments.

In Scotland, Hepatitis C infection can be caught by injecting or snorting any drugs, including bodybuilding drugs. Other risks include tattoos (particularly home tattoos), previous blood transfusions, needle stick injuries, sharing piercings, attending traditional barbers using open blades whilst on holiday, or having undertaken any medical, surgical or dental treatments abroad. Hepatitis C is infrequently spread by sexual activity, but other blood borne viruses such as HIV and Hepatitis B are more commonly spread in this way.

NHS Forth Valley’s Strategic Lead, Dr Pete Bramley added: “It can take as long as 20 to 30 years for serious liver damage caused by Hepatitis C to become apparent with increasing symptoms, hence the ‘silent killer’ label. Over the past few years, testing, treatment and care service provision has increased dramatically. “Diagnosing and treating people who are unaware of their infection will improve their quality of life and prevent risks of future ill health and, in turn, prevent onward transmission to uninfected people and the wider public.”

For more information or advice on blood-borne viruses and testing please contact Wendy Mitchell, NHS Forth Valley’s BBV Community Champion on 01786 434079 or visit the NHS Forth Valley website.