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‘ We need to engage at all levels to reach this population ’

THERE ARE TENS OF THOUSANDS OF PEOPLE in the UK who have already been diagnosed but have not yet been treated .
Some of these people will know that they have the virus , but are not engaging with treatment services for whatever reason . Others might have been tested at some point in their past and be unaware of their status .
To reach the first group , we need to understand that hepatitis C is a disease of vulnerable people

REMOVING BARRIERS

Case study 2
Awareness initiatives can counter the fear of outdated treatment methods who might lead chaotic lifestyles , which means testing and treatment must be available where vulnerable people access care – not only GP surgeries but homeless shelters , needle exchanges , sexual health clinics , pharmacies and amongst the prison population .
To reach the second group , we need them to reengage with services entirely . We have highly effective medicines that can cure the virus and we need to get the word out there that it can be

HIDDEN HARM

Case study 3 cured . Raising awareness and fighting stigma is critical to the success of this ambition .
If people don ’ t know they are at risk , they won ’ t get tested or treated , risking serious health problems in the future . We have a moral obligation to do everything we can to reach this population of hepatitis C patients .
Prof Ashley Brown , vice chair of the Hepatitis C Coalition and hepatitis C lead for North West London
People often have no idea that they have hepatitis C when symptoms merge with a chaotic lifestyle
Change Grow Live ( CGL )’ s national hepatitis C strategy aims to support all individuals who use or have used drugs intravenously to have regular access to finger-prick testing for the virus .
At the same time , preventative harm reduction advice is shared with atrisk populations by outreach teams working directly with people using drugs in high prevalence areas , on the streets or in hostel accommodation . For those who are aware that they have hepatitis C , CGL staff recognise that adverse reactions to previous treatment methods can be a barrier to re-engaging with treatment .

Previously disaffected cohorts are much more willing to re-engage with treatment

In the recent past , some individuals opted to stop treatment prematurely rather than endure the painful side-effects of the medication . Even for those who completed treatment , the cure rate was variable .
At the beginning of July 2018 , CGL promoted hepatitis C awareness across their treatment centres , explaining the importance of testing and the range of antiviral treatments now available .
Previously disaffected cohorts are much more willing to re-engage with treatment in the knowledge that the standard of care is different now .
Alesha in Northampton had previously been treated unsuccessfully with interferon injections , and had experienced multiple , serious side effects as a result . With the support of CGL , she began treatment with direct acting anti-viral tablets , and is now clear of hepatitis C .
Originally from South Africa , Billy has been living in London since 1988 . While she was on a flight at the age of 18 she took her first sleeping tablet , and from then until 2010 she felt a sense of belonging through using various pills . Over the years Billy developed a long history of recreational and medicinal drug and alcohol misuse , including heroin , and battled with numerous mental health problems .
Almost ten years ago , and while still using drugs , she went to the Red Cross in Oxford Street to give blood . She had no symptoms of hepatitis C and was not expecting the positive result . When she had the news , doctors referred her to take part in the first trial for interferon treatment at St Mary ’ s Hospital in London .
Billy recalls that at that stage in her life , everything was rather chaotic and it would have been difficult for her to detect if she had been experiencing any of the symptoms such as tiredness . She was unsure of how she contracted it , whether it was due to intravenous heroin-taking or from other blood transfusions in the UK and SA .
The treatment was painful and uncomfortable but it worked and cured Billy from hepatitis C . Despite periods of sobriety , it was only in 2010 with the support of DWP – now Turning Point Drug and Alcohol Wellbeing Service ( DAWS ) – that her life changed permanently for the better . She joined a day programme and became involved with the service-user involvement groups , and now runs a jewellery designing and making course at drug and alcohol services at Turning Point and CGL . She has recently completed her peer-mentor training and hopes to use her recovery journey to support others .
Billy has also received training from the Hepatitis C Trust and hopes to become involved soon in testing via dry blood spots at Turning Point services . www . drinkanddrugsnews . com Wider Health Series | DDN | 7