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New Pathway for the Treatment of Patients with Hepatitis C

The Health Protection Agency estimates that there are 250,000 people with Hepatitis C in the UK, while some estimates put the prevalence as high as 466,000. Most people go undiagnosed and less than half receive treatment.

Hepatitis C is a blood-borne virus that can cause inflammation, swelling and scarring of the liver tissue, and often leads to significant liver damage. Greater Manchester has the highest levels of hepatitis C in England, with estimates reaching around 16,000 cases, due largely to its high prevalence among the sizeable local injecting drug using population. Without a doubt, hepatitis C is an escalating public health issue that will cost the NHS up to £8billion over the next 30 years unless testing and treatment is improved.

The Greater Manchester Hepatitis C Strategy, in partnership with NHS Greater Manchester, has developed a new clinical care pathway for the treatment of people with suspected hepatitis C. The new pathway puts patient care at the heart and will streamline and shorten the various processes a patient needs to go through.

At present, General Practitioners carry out a basic test on patients to see if they have hepatitis C antibodies in their system. About 20-30 per cent of people clear the virus from their bodies and so the problem with this test is that it does not show if the virus is still present. This means the patient is then referred to secondary care i.e. hospital, for further tests.

What the new pathway promotes is for GPs to do a PCR test (polymerase chain reaction) which detects whether or not the hepatitis C virus is still in the patient's system. This cuts out the need for patients to be referred to secondary care, wait to see a Consultant and then wait for testing and results. Patients who show as positive in both tests will then be referred directly to the nearest or preferred treatment centre instead of being referred to a local gastroenterologist first. In Greater Manchester there are four treatment centres including North Manchester General Hospital (Lead Consultant, Dr Vilar), Manchester Royal Infirmary (Lead Consultant, Dr Prince), Royal Albert Edward Infirmary (Lead Consultant, Dr Banait), and Wythenshawe Hospital (Lead Consultant, Dr Newton).

Overall, the new pathway minimizes waiting time for patients. Siobhan Fahey, Programme Manager for the Greater Manchester Hepatitis C Strategy says: "The new pathway is designed to cut out additional steps that the patient currently has to take in finding out whether or not they have hepatitis C and getting it treated. The changes will provide savings to the NHS which at this point in time is a real necessity.

"The pathway will certainly help patients as they will be tested more promptly, receive the results much more quickly and this in turn will reduce the anxiety and worry that they will no doubt be feeling. We are in the process of meeting GPs across Greater Manchester, providing training on the new pathway and providing various literature."

 For more information, advice and guidance please visit www.greatermanchesterhepc.com.

 

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Notes to editors

 

Media contact

Laura Parker, Communications Manager for the Greater Manchester Hepatitis C Strategy, t: 07812 087 047.

 

About Hepatitis C

Hepatitis C is a blood-borne virus that infects the cells of the liver.

It can cause inflammation

(swelling) and fibrosis (scarring) of the liver tissue, and sometimes significant liver damage. It ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. 

Hepatitis C is spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Those at risk are:

  • Those who currently or have previously shared needles, syringes, straws or other equipment to inject or snort drugs
  • If you were in receipt of a blood transfusion or transplant before 1991
  • If you were in receipt of blood products before 1987
  • People born oversees may have been exposed to re-used needles or given contaminated blood. HCV rates in Pakistan for example is 3%. In Greater Manchester there are around 29,000 people living here who were born in Pakistan which means around 1,115 could be infected

 

  • Patients who have received health care abroad in countries where medical equipment may be inadequately sterilised are at increased risk. This particularly applies to people born in developing countries, who may have been exposed to increased risk of infection
  • People who have had acupuncture, tattoos or body piercing - this can be due to either improperly sterilized equipment or contamination of any dyes being used
  • Needlestick injuries in health care settings
  • Sharing personal care items that may have come in contact with another person's blood, such as razors or toothbrushes
  • Having sexual contact with a person infected with the Hepatitis C virus
  • Being born to a mother who has Hepatitis C.

 

About the Greater Manchester Hepatitis C Strategy

The Greater Manchester Hepatitis C Strategy (GMHCVS) was formed in response to the national Hepatitis C Strategy in 2004 and increasing local recognition of a need to improve local services in Greater Manchester. Hepatitis C is a serious public health issue for the North West and Greater Manchester in particular has consistently had the highest rates of infection in injecting drug users in the country. Hepatitis C is regarded by the North West Strategic Health Authority as one of the top five health issues for the region and has been identified by NHS Greater Manchester as one of the top twenty health priorities.