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Welcome to the latest Hepatitis Scotland e-Bulletin.
People living with Hepatitis B or Hepatitis C qualify for a free flu vaccination. It is important that those affected by these viruses have access to the flu jab as there is significant mortality associated For more information on who should be getting a flu jab and where to get it, visit Immunisation Scotland's website.
The 2014 update of Shooting Up, charting infections among people who inject drugs, has been published. Among key findings are:
• Hepatitis C infections are still high among people who inject psychoactive drugs such as heroin and mephedrone. Around 2 in 5 of these people are living with Hepatitis C and around half are undiagnosed. Around 1 in 30 people who inject image and performance enhancing drugs such as anabolic steroids are infected with Hepatitis C.
• Hepatitis B infection among people who inject psychoactive drugs has declined in recent years however vaccine uptake is much lower among people who inject image and performance enhancing drugs.
• Reported needle and syringe sharing has halved over 10 years but around 1 in 7 people injecting psychoactive drugs share needles and syringes and almost 1 in 3 had injected with a used needle they had attempted to clean.
• Changing patterns of psychoactive drug injection have shownan increase in injection of amphetamines and amphetamine type drugs such as mephedrone.
AMCD advises OST should not be time limited
In their advice to the UK Government the ACMD said that they do not advise time limiting opioid substitution therapy for heroin users as the evidence strongly suggests this would result in the majority relapsing into heroin use with significant unintended consequences including increasing drug driven crime, heroin overdose death rates; and the spread of blood borne viruses such as HIV and viral hepatitis.
OST associated with lower HCV incidence among young IDU
New research published online in the JAMA network has shown that recent maintenance opioid agonist therapy is associated with lower incidence of Hepatitis C among young adult injection drug users. It concludes maintenance treatment with methadone or buprenorphine may be an important strategy in preventing HCV infection in this group.
This collection of research articles and commentaries look at various important issues around viral hepatitis and drug use in Europe. It includes an article looking at a voluntary sector perspective of Scotland ‘s Hep C Action Plan.
• Improved HCV screening and treatment in PWID should be a priority in Europe
• The successful implementation of Scotland’s Hepatitis C Action Plan: Learning for European stakeholders. A voluntary sector perspective.
• Ending the mass criminalisation of people who use drugs: a necessary component of the public health response to HCV
• Hepatitis: A devastating epidemic in Europe
• A treatment revolution for those who can afford it? HCV treatment: new medications, profits and patients.
• HIV and Hepatitis C co-infection in Europe, Israel and Argentina: a EuroSIDA perspective
An aspirin a day may keep fibrosis at bay
Emerging evidence presented at The Liver Meeting 2014 in the USA has suggested that aside from having potential benefits for cardiovascular conditions and anti inflammatory properties, may also reduce liver fibrosis. In a population based cross sectional study of more than 14,000 adults there was a ‘consistent association between aspirin use and less liver fibrosis’. The researchers conducted analysis for patients with viral hepatitis, who were heavy drinkers and patients with fatty liver disease.
Obesity accelerated aging in liver tissue
New study data has shown that obesity is strongly correlated with an advanced epigenetic age of liver tissue. The acceleration in age of the liver was not associated with non alcoholic fatty liver disease score or any other traits after adjusting for BMI.
The acceleration in liver age could play a role in liver related medical conditions, such as liver cancer and insulin resistance, according to the researchers. The researchers said this once again stresses the importance of maintaining a healthy weight.
Mild Liver disease common at lymphoma diagnosis in HCV patients
Data presented at the AASLD/EASL Special Conference on Hepatitis C has shown that Hepatitis C patients often showed signs of mild liver disease when diagnosed with HCV related non Hodgkins Lymphoma.
Gay men's knowledge of Hepatitis C in Scotland
Research presented at Gaycon 2014 has presented a snapshot of gay men's knowledge and concerns about Hepatitis C in Scotland. Whilst all men surveyed had heard of or knew something about Hepatitis C, and were worried about being at risk of it, they did not consider it to be an urgent issue. More than 50% reported having been tested and received a negative Hep C diagnosis, with 4% reporting having previously received a positive Hep C diagnosis.
Among important issues raised were a preference among some HIV positive men to have unprotected sex with other HIV positive men (serosorting) as a way of reducing risk.
*Other related presentations on this topic include:
Australian young people and gay men show lack of Hep C awareness
A wide ranging report by the University of New South Wales’ Centre for Social Research in Health has found that Hepatitis C knowledge in young people and gay men is dangerously low. 11% of young people surveyed (757 respondents) reported exposure to injecting in the previous 12 months either through friends or a partner who injected, or having been offered drugs to inject.
The report also showed a lack of knowledge of Hepatitis C among gay men. 41% of those who had injected reported reusing, sharing or passing on needles, syringes or other injecting equipment, and sharing commonly occurred with regular and casual sex partners.
US study of Hepatitis C in young adults
Meanwhile the US CDC has awarded a grant to New Mexico to study Hepatitis C in young adults, against a background of an emerging epidemic in people who are young and new to drug injection.
A new campaign has been launched on the Isle of Wight aiming to identify the 200 people on the island living with Hepatitis C. Pharmacies are offering free testing, with promotional activity running on busses, in local press and on radio.
In previous e-bulletins we have reported studies linking Hepatitis C infection to the development of type 2 diabetes. The link between the 2 has been questioned in recent US research seeming to suggest that there is no link, while recent European research maintains that there is.
The European Initiative on Hepatitis C and Drug Use has launched a petition encouraging the development of European and national strategies to provide access to Hepatitis C prevention, testing, treatment and care for people who use drugs.
Hepatitis Scotland and the Hepatitis C Trust are pleased to announce the publishing of the report on Scotland's Hepatitis C Patient Conference which took place in March 2014. The conference was a huge success with over 100 Hepatitis C patients in attendance.
The Evaluation Report of World Hepatitis Day in Scotland has been completed and is now available on the Hepatitis Scotland website. 2014 saw a re-run of the Big Red C bus ad campaign along with 18 awareness raising events and conversation cafes taking place across Scotland. You can view the national Conversation Cafe report here.
The World Hepatitis Alliance have also published their report on World Hepatitis Day events and activities which took place around the world, including the International Event which took place in Glasgow's St Enoch Square
You can view the latest edition of the Journal of Hepatology here.
Alex Murray was a founding member of the National Patient Forum from January 2012 until his death earlier this year.
Alex was committed to the Patient Forum, learning about what was happening around Hepatitis C in Scotland so he could pass on the information to others in his local area.
He will be remembered for his humour, his passion and his wanting to make services better for others affected by Hepatitis C in Scotland, especially those unable to have treatment.
Our deepest sympathies go to his family and friends and he is greatly missed.