Hep C Discussion Forum

Well yes, that`s the weak point of the scheme really, I think.  Having free needle exchange points is one thing that should help stop reinfection, and I imagine once someone has been through tx and cleared the virus they would have more incentive to get off drugs, or at least stop injecting drugs and/or sharing needles and other paraphernalia.  Old habits are hard to break though so I should think it would also take a lot of ongoing support from trained nurses or support workers in the field, which all costs money.  It will be interesting to hear how successful the scheme turns out to be.

I can't see it, need to subscribe to them.

Ok, thanks for letting me know.  I`m not actually subscribed but for some reason the link still works for me. 

Anyway, here are the main points...

`Scotland, with a population of only five million, has launched a £100 million (about $150 million) program, running from 2008 to 2015, to diagnose and treat hepatitis C, regardless of the patient's history.  Medication alone can cost anywhere from $10,000 to $40,000 per patient.`

`To find infections in current drug users, Scotland is blanketing needle exchanges with simple finger-prick diagnostic kits.  After identifying people with infections, many parts of Scotland try to start weaning them off heroin before offering hepatitis C medication.  The typical approach is to prescribe methadone, a synthetic opiate that can help reduce heroin cravings, and wait for the patient to gain some stability, says John Dillon, a doctor in Dundee who helps run the hepatitis C program, which is staffed with about 85 doctors and nurses.`

`But Dundee and other regions have started treating drug users without necessarily trying to stabilize them on methadone first.  They are motivated by research from University of Bristol, London School of Hygiene and Tropical Medicine and other institutions suggesting that if just 20 out of 1,000 active injection drug users are treated each year, it could stop them infecting others and reduce the rate of hepatitis C prevalence by nearly 30% in 10 years.`

`Many countries don't treat active drug users or patients taking methadone because of this risk: they fear the money and effort will be wasted if the person continues using illicit drugs and gets reinfected.  "There's been an argument, if you have constrained resources, who would you treat first?  Obviously not drug users.  But actually there's an argument that you should treat them first," says Charles Gore, president of the World Hepatitis Alliance in London.  In Scotland and many places, injection drug use is by far the biggest source of the virus's transmission.  Stopping that transmission is "a way to turn off the tap, and then we can empty the pool," Mr. Gore says.`