Leading medical experts from throughout the UK will be gathering in Edinburgh today and tomorrow (21-22 April 2004) to arrive at a consensus on how best to treat and manage the 'silent epidemic' of hepatitis C - a virus which is estimated to be carried by over 400,000 people in the UK and which continues to spread globally, as the majority of carriers do not realise they have been infected.
The hepatitis C virus was first reported in 1989 and is a major cause of liver disease, with 170 million people worldwide believed to be infected with the virus. The spread of the virus is predominantly blood-borne with the main route of transmission in the UK being intravenous drug use (and, in particular, needle sharing). It has also been transmitted by blood transfusion, prior to the introduction of screening for the virus in 1991, and by unprotected sex. Additionally, it is thought possible that sharing personal hygiene items such as razors or toothbrushes might contribute to the spread of the virus. The main implications of hepatitis C are that carriers can develop cirrhosis of the liver (in which the liver is gradually destroyed, leading eventually to liver failure) or liver cancer over a period of 20-30 years. It is estimated that up to 20% of hepatitis C carriers could develop cirrhosis and require liver transplantation, putting significant pressure on transplantation services which are already experiencing a shortage of donor organs.
While treatment of hepatitis C can be successful (60-70% of sufferers receiving the most effective combined treatment of ribavirin and interferon will become clear of the virus in the long-term) a number of difficulties can be encountered - treatment can be costly, ranging from £7,500 (for six months treatment) - £12,000 (for 12 months treatment) per person, thus placing financial strain on the NHS; treatment can be difficult to organise, due to shortages in specialised medical and nursing staff required to monitor the lengthy treatment regimes (side effects can range from severe depression to anaemia, so close monitoring is required); and patients can experience waiting lists of up to 2-3 years for treatment (during which their health can deteriorate further).
In order to provide much-needed clarity and guidance for health professionals and patients alike, the Royal College of Physicians of Edinburgh has convened a consensus conference on hepatitis C. At the conclusion of the event a 'consensus statement', containing agreement on five key aspects of hepatitis C treatment, will be produced and the statement will be disseminated to medical staff throughout the UK in addition to being submitted to both the Department of Health, at Westminster, and the Scottish Executive in order to inform future health policy on this area.
Prof. Peter Hayes, from the Royal College of Physicians of Edinburgh, and a consultant gastroenterologist, said,
"Hepatitis C presents us with a major health challenge, both throughout the UK and globally. Its reputation as the 'silent epidemic' is well earned, as carriers often do not know they have been infected and, in turn, pass the virus on to others. The scale of the spread of hepatitis C has become clearer in recent years and has reached epidemic proportions with an estimated 40,000 people in Scotland and up to 400,000 in England and Wales carrying the virus. It is, therefore, vital that people who have contracted the virus learn that they are carrying it, through testing, so that we can reduce further transmission and introduce effective treatment at an early stage. By gathering together experts from throughout the UK we are confident that we will be able to produce much needed guidance for medical staff and the public alike on this important area".