Tackling the hepatitis C virus (HCV) 'pandemic' is now seen as a key public health priority as approximately 60% of all diagnosed patients in Europe remain untreated,1 with the risk of late diagnosis potentially leading to liver cirrhosis and cancer. This is despite new European treatment guidelines advocating targeted screening for HCV infection and the use of new direct-acting antiviral agents in preference to the older interferon-based regimens.2

To coincide with World Hepatitis Day on July 28th, United European Gastroenterology (UEG) Vice President and liver specialist, Professor Michael Manns, calls for improvements in national strategies for HCV screening and treatment to ensure that more people are diagnosed as early as possible and have the best possible chance of a cure.

"Current treatment regimens for HCV infection can eradicate the virus in up to 100% of people treated, depending on the type of virus, the drug combination used, and the general health of the individual," says Prof. Manns. "With possible cure rates as high as these, we have the potential to eradicate this infection, preventing many cases of chronic liver disease, and saving thousands of lives."

The European Association for the Study of the Liver (EASL) has recently published guidelines for the treatment of HCV infection that recommend that screening for HCV infection should be implemented in targeted populations defined according to local infection trends, ideally within the framework of national plans.2 The guidelines recognise the differences in healthcare funding across Europe, but aim to harmonise HCV treatment across its different countries and regions.

"These new guidelines include recommendations for the use of the newer treatments that, cost issues aside, should ideally replace the older interferon-based regimens," says Prof. Manns. "Our universal goals, which are reflected in these European guidelines, should be to identify and cure as many people as possible with chronic HCV infection, thereby preventing its spread and limiting its serious health consequences."

It has been estimated that approximately 9 million people in Europe are chronically infected with HCV, with 86,000 HCV-related deaths occurring in Europe each year1. Chronic HCV infection ­frequently leads to liver damage and cirrhosis that may progress into liver cancer. The UEG Survey of Digestive Health Across Europe reports that in western Europe HCV leads to 40% of all cases of liver cirrhosis and 60% of all cases of hepatocellular cancer 3.

Unfortunately, receiving a diagnosis of HCV infection does not guarantee access to treatment. A recent systematic review of the European literature found that HCV treatment rates varied by country, with the lowest rates reported in Eastern and North-West Europe (e.g. UK, Russia) and the highest rates reported in Italy.1 Barriers to treatment in those with a diagnosis include a failure to seek treatment, a lack of financial resources and ongoing injection drug or alcohol abuse".1,4 Studies have also found that the single most important barrier to HCV treatment is a lack of awareness, with up to 75% of people living with chronic HCV infection unaware that they have the infection.4