As the world remains off track to eliminate viral hepatitis by 2030, accelerating access to testing and treatment of hepatitis C has become more important than ever. The NOhep Medical Visionaries Forum brought together healthcare professionals, experts and advocates to discuss practical and innovative approaches to reducing the gap between testing and treatment, accelerating elimination efforts.
Dee Lee, President, World Hepatitis Alliance (Chair)
Maria Buti, Professor of Medicine and Consultant of Hepatology, University Hospital Vall d’Hebron
Prof Ashley Brown, Consultant Hepatologist & Professor of Practice, Imperial College Healthcare NHS Trust, UK
The forum saw the launch of the new TEST. TREAT. ELIMINATE. toolkit, developed to be a practical guide for healthcare professionals. It outlines the importance of testing and treatment of hepatitis C, approaches to expanding access, simplified care pathways and meeting patients where they are.
An update was provided on the key outcomes from the recent WHA organised EU Parliamentary meeting on liver cancer and hepatitis, highlighting how the discussion fits within a broader policy context including the Lancet Commission on liver cancer. It was noted that hepatitis is an oncogenic virus, which is poorly understood and whilst many people are being diagnosed, the failure to link people to care is unacceptable. The below calls to action for healthcare professionals across both hepatitis B and C were outlined:
The full toolkit will be launched soon.
The importance of same day test and treat for hepatitis C was a focus of the forum. Delays in treating people carries a psychological burden, impacting the whole person and not the just the liver. Same day models of care mean that services meet people where they are, rather than expecting them to attend a follow up appointment. This can be facilitated in numerous ways, including, pharmacist partnerships, peer workers with lived experience and mobile van dispensing – in Yorkshire people are receiving medication directly via mobile vans. It was also noted that while fibroscans are valuable, they should not be a barrier to starting treatment and can be done at a later date. An example of a test and treat model in practice was shared: while at EASL, a positive self-test result was received on a phone by a hepatologist and within 20 minutes, the person was contacted by a member of the medical team and linked to care that same afternoon.
Further discussion between the speakers and audience highlighted a constant theme that in many settings, diagnosis is not the greatest challenge, but linkage to care is. Participants explored how to better reach people who move frequently or cannot access patient services. Examples from the UK, Spain and India showed the values of community-based care, digital health tools, prison programmes, peer support networks and innovative approaches to treatment delivery. There was also discussion about opportunities to further simplify diagnostics, including the role of rapid core antigen testing and use of point of care technologies.
By translating policy commitments into practical action and prioritising linkage to care, healthcare professionals can play a critical role in accelerating progress towards the elimination of hepatitis C.
