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GPs should administer Hep C therapy, says WHO

WHO issues first Hepatitis C treatment guidelines

Adrian O'Dowd

Thursday, 10 April 2014

GPs should be involved in administering Hepatitis C therapy to patients as part of a new drive to improve screening, care and treatment of the infection, according to the World Health Organization (WHO).

WHO has published its first guidance for the treatment of hepatitis C, the chronic infection that affects an estimated 130 million to 150 million people and results in 350,000 to 500,000 deaths a year. 

Published to coincide with the 2014 International Liver Congress, taking place this week in London, the WHO Guidelines for the screening, care and treatment of persons with hepatitis C infection, contains recommendations based on a thorough review of the best and latest scientific evidence.

WHO said it would be working with countries to introduce the guidelines as part of their national treatment programmes. It would provide help to make new more effective and safer oral hepatitis medicines available with consideration of how to make them affordable for all while also assessing the quality of hepatitis laboratory tests and generic forms of hepatitis medicines.

The guidance says: “Currently, HCV [hepatitis C virus] therapy is provided in specialised centers by hepatologists or other subspecialists.

“For HCV therapy to be expanded, it will need to be administered by general-practice physicians and other health care workers in primary-care clinics. To accomplish this, clinics will need to be equipped and many more health care workers will need training in the clinical management of HCV infection.”

The new guidelines make nine key recommendations, including approaches to increase the number of people screened for hepatitis C infection, advice on how to how to mitigate liver damage for those who are infected and how to select and provide appropriate treatments for chronic hepatitis C infection.

WHO recommends a screening test for those considered at high risk of infection, followed by another test for those who screen positive, to establish whether they have chronic hepatitis C infection.

Given that alcohol use can accelerate liver damage caused by hepatitis C, WHO now advises that people with chronic hepatitis C infection receive an alcohol assessment and for clinicians to provide counseling to reduce alcohol intake for people with moderate or high alcohol use.

Dr Stefan Wiktor, who leads WHO’s Global Hepatitis Programme, said: “The new guidance aims to help countries to improve treatment and care for hepatitis and thereby reduce deaths from liver cancer and cirrhosis.”

Dr Andrew Ball, senior advisor for policy, strategy and equity for WHO’s HIV/AIDS department where the Global Hepatitis Programme is housed, said: “Many people remain unaware - sometimes for decades - that they are infected with hepatitis C.

“Today’s launch highlights the need for more awareness and education on hepatitis for the general public. Greater awareness on the risks associated with hepatitis C should lead to a demand for services and expansion of laboratory capacity and clinical services so that more people can be tested, treated and cured.”

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