10,000 people exposed to Hep C in Dublin

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10,000 people exposed to Hep C in Dublin

The Blood Borne Virus Forum has called for a regional hepatitis C strategy developed in 2004 to be published and rolled out nationally. Addressing the Joint Oi­re­achtas Health Committee, the Forum said some 10,000 people in Dub­lin are exposed to hepatitis C at present and people across the country are at risk of contracting the virus because they are not aware of the risks. According to Mr Cumberton, a community de­vel­opment worker with Donore Community Drug Team in Dublin, people using straws and banknotes to snort cocaine are not aware of the risks of contracting hepatits C through blood to blood infection, through nosebleeds on to notes or straws. He said: “they are astounded when I make them aware of the risks because they do not see themselves as drug users. When they use cocaine only at weekends, they do not see themselves as drug users because they do not take it every day or do not inject heroin. “However, they are sharing the paraphernalia in toilets in pubs and nightclubs.” Ms Flanagan, a hepatitis C nurse specialist with the HSE in north Dublin, said there are approximately 14,000 drug users in Dublin and “statistical projections are that between 70 per cent and 80 per cent will be infected with hepatitis C if they inject longer than six months. This means that approximately 10,000 people in Dublin are exposed to hepatitis C at present. She told the committee, however, that there is “momentum within the prisons” for change to occur. According to a study done by the Forum in 2000, some 37 per cent of prisoners were exposed to hepatitis C through antibodies and “we noticed up to 81 per cent prevalence in injecting drug users in prison”. She added that people with a history of drug use who are recommended for treatment present problems since “they have many complex needs and these cannot often be met at hospital level as it requires more in-depth service provision. This is not currently available. We are seeking to develop support services to enable people to fully access treatment”. Patients are not supposed to wait more than an hour in any outpatient setting or any more than two weeks to be seen by a specialist and, according to the Forum, this State-devised strategy is comprehensive. However, Ms Flanagan said “no definitive policy or strategy is in place to deal with prevention and management of hepatitis C for the remaining majority (those who either do not know how they were infected through certain risk-taking or were infected through sharing drug-use equipment)“. No allocated budget was made for the largest prevalence group making it difficult to develop services, she said. According to Ms Flanagan there are services available to people who become infected, “however, more definitive needs such as counselling services and community supports are not available because no identifiable budget or strategy is in place. They use separate clinics to those infected by blood and blood produce and must wait.” Treatment of one hepatitis C patient can cost approximately E16,500. One uncomplicated transplant can cost between E28,000 and E56,000 and the Forum envisages large numbers in the future. As regards awareness, the Forum said there are currently only two community workers in the country providing information and delivering workshops to the community on hepatitis C and HIV. Ms Flanagan added that some GPs are not very aware of the issues relating to hepatitis C “and it may not be high on their lists of priorities as so many illnesses exist. “Patients may receive a diagnosis but may not have comprehensive information for follow-up and may not un­­de­rstand how chronic and serious a condition hepatitis C is.” According to the Forum a regional hepatitis C strategy was drawn up in 2004 through the former ERHA and is currently under review again. “As there is such a high prevalence of hepatitis C in Ireland, managing it and reducing future infection will require quite a lot of effort from many depart­ments. We are looking at significant service developments. Harm re­duction programmes are al­ways controversial,” Ms Flan­­agan said.

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