National Hepatitis C Strategy 2011-2014

The Health Service Executive recently launched its National Hepatitis
C Strategy, which provides a framework for a coordinated and
integrated response to Hepatitis C in Ireland. It is estimated that
between 20,000 and 50,000 people in Ireland are infected with the
Hepatitis C virus. There is very effective treatment now available
for Hepatitis C, which eliminates the virus in over 50% of cases.
However, there is still a need for a coordinated approach to
surveillance, treatment and support.

Many people are still unaware of the risk factors for contracting
Hepatitis C and unknowingly engage in behaviours that put them at risk
of contracting the virus. Injecting drug use is the leading risk
behaviour for transmission of Hepatitis C. In particular, the sharing
of injecting equipment poses the greatest risk of exposure to the
Hepatitis C virus (prevalence in population of injecting drug users in
Ireland ranges from 62% – 81%).

The National Hepatitis C Strategy lays out a clear plan with timelines
to reduce transmission of Hepatitis C and to improve the care of
patients infected with Hepatitis C in Ireland. Implementation of the
Strategy will be challenging in the current climate, however, a number
of the recommendations are already well underway. Other cost neutral
recommendations which promote an enhanced, integrated approach towards
care and management of Hepatitis C infected service users will be the
initial focus of implementation.

Summary of the Recommendations

Surveillance
▪ Strengthening of the Hepatitis C notification system;
▪ Enabling appropriate follow up on newly diagnosed cases;
▪ Improving knowledge around Hepatitis C infection in Ireland.

Prevention
▪ Prevention of infection through initiatives targeting drug use;
▪ Developing targeted strategies for socially excluded groups;
▪ Promoting guidelines governing tattooing, permanent makeup or body piercing;
▪ Enhancing provision of up-to-date, accurate communication and
information around Hepatitis C.
Screening and Laboratory Testing
▪ Access to diagnostic facilities, release of results of screening etc.
▪ Screening of new entrants to the health system.
▪ Issues around screening and uptake among the prison population.

Treatment
▪ Guidance on clinical issues;
▪ Barriers to treatment uptake and adherence;
▪ Hepatitis C care in custody;
▪ Overall care issues around Hepatitis C.

The full Report can be found at:-
ww.hse.ie/eng/services/Publications/HealthProtection/HepCStrategy.html

Background
Hepatitis C is a slow-progressing, blood borne viral disease that
requires laboratory confirmation for diagnosis. Often, people are
unaware they are infected until symptoms present many years later.
Hepatitis C is a major cause of acute hepatitis and chronic liver
disease, including cirrhosis (up to 20%) and liver cancer.

The development of a National Hepatitis C strategy was commissioned by
the HSE National Social Inclusion Unit which has a strategic remit for
Addiction services. The strategy was led by Professor Joe Barry of
Trinity College via a Steering Group and three designated Working
Groups – Surveillance, Treatment and Education, and Prevention and
Communication.

Membership of groups comprised representatives from a range of sectors
and disciplines, including primary and acute services, public health,
addiction, health promotion, social inclusion health professionals and
managers, as well as expertise from relevant community and voluntary
sector agencies.