Addictions and the liver

Transcription

1 Addictions and the liver John Logan Consultant t in Public Health Medicine i NHS Lanarkshire BBV Executive Lead Co-chair, Sexual Health & BBV Executive e Leads Group john.logan@lanarkshire.scot.nhs.uk

2 Welcome (back) Fire alarm and fire exits Toilets This afternoon s programme Hepatitis C SC, DW, MH Liver transplant Qs and As Poster presentations and stalls Feedback fiona.mcintyre2@lanarkshire.scot.nhs.uk

3 One minute manager challenge 1. Introduce yourself. 2. One thing that you learned this morning something you didn t know before. 3. One change to your practice or that t of your team/service/department that you intend to make and how this will lead to improved outcome.

4 Hepatitis C in Lanarkshire Epidemiology SG Sexual Health & BBV Framework Lanarkshire BBV Prevention & Care Network New drugs ET

5 Epidemiology NANB HCV identified in (2094) Lan. residents HCV Ab pos 140 to 190 HCV Ab pos each year 25 to 35 / 100, to 90 people initiated on to treatment each year (NHS Lanarkshire)

6 Transmission of infection Mostly through sharing injecting equip Healthcare (txf, txp, sharps, equip) Sexual intercourse Tattooing and piercing Shared personal items razors, toothbrushes, manicure/pedicure equip Vertical (pregnancy/delivery)

7 Male: female 2:1 Age group at diagnosis , , Source of referrals GP, hosp patients, t drug service, sexual health, prison

8 Number of hepatitis C antibody positive diagnoses made in Lanarkshire residents and percentage of all diagnoses made in Scotland by year mber Nu Year 0.0 Number Percentage

9 Percentage of Lanarkshire residents diagnosed positive for hepatitis C antibody by age group and by year age Percent 30 < < Year

10 Sexual Health & BBV Framework Hepatitis C - outcomes Fewer newly acquired hepatitis C infections A reduction in health inequalities associated with hepatitis C People affected by hepatitis C lead longer, healthier lives A society whereby the attitudes of individuals, the public, professionals and the media in Scotland towards hepatitis C are positive, nonstigmatising and supportive.

11 Hepatitis C - indicators HCV 2.1 Rate of HCV diagnosed population accessing specialist services by population group. HCV 3.1 Number of people diagnosed and this number as a proportion of the estimated infected population. HCV 3.33 Annual number of hepatitis C diagnosed d persons hospitalised, or having died with end-stage liver disease; total and within 1 year of diagnosis. HCV 3.4 Ratio of the diagnosed HCV chronically infected population to the annual and total number of people initiated onto antiviral therapy.

12 HCV 3.5 The proportion of the treated HCV population that completes treatment and the proportion achieving a sustained viral response. 51A 5.1 Acceptability of services to those living i with, or vulnerable to, poor sexual health and/or blood borne viruses (including prevention, treatment, care and support services). BBV 5.2 Awareness and understanding di in the general population of blood borne viruses including transmission, treatment and complex long-term health issues of living with blood borne viruses, to support those living with and at risk of blood borne viruses to feel a sense of inclusion and equality in society. BBV 5.3 Positive portrayal of sexual health and blood borne virus issues in the media, including the portrayal of gender stereotypes, nationally and locally.

13 Lanarkshire BBV Prevention & Care Network Lanarkshire NHS, NLC, SLC, 3 rd sector, patient and carer representation BBV covers Hep C, Hep B and HIV Prevention (primary, secondary, tertiary), diagnosis, clinical assessment and management including drug treatment, social care, support, and after care Complex situation so local managed network and national networking

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19 New drugs More effective very high cure rates Many drugs and several drug companies Simpler drug dosage regimes Shorter treatment periods Fewer side effects BUT Very expensive Concern regarding risk compensation

20 So Hepatitis C clinicians developing guidance National Sexual Health & BBV Advisory Committee Subgroup Strategy for new hepatitis C therapies First meeting 3 rd April Symposium in September Strategy by the end of 2014

21 Take home message Engage with the BBV P&C Network Test for hepatitis C venous or DBST

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23 Any questions, suggestions, requests etc regarding the BBV Network scot nhs uk BBV Network Manager scot nhs uk BBV Network Administrator