Guide sur la mise en place de services spécialisés en hépatite C

Pour réduire la transmission de l’hépatite C, les Directeurs de Santé Publique doivent absolument prendre conscience de l’importance des programmes de dépistage et d’éducation. Pour en savoir plus, en anglais, veuillez lire les informations ci-dessous.

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The number of people who die from liver disease in England has risen by 25% in the last decade. This is in contrast to the other major causes of death in this country, which affect fewer people at a later age than ever before, while liver disease affects growing numbers of increasingly younger people.

• Liver disease causes approximately 2% of all deaths
• 90% of people who die from liver disease are under 70 years old
• More than 1-in-10 deaths of people in their 40s are from liver disease
• People dying from liver disease often have complex end of life care needs and over 70% die in hospital

The NHS and Public Health Outcomes Frameworks both set an ambition for reduction of mortality in people under 75 years from liver disease. The main causes of liver disease are alcohol abuse, obesity and viral hepatitis B and C.

The Office of National Statistics has listed hepatitis C as the only liver disease which is ‘amenable’, meaning death from hepatitis C can be avoided through good quality healthcare. It also lists hepatitis C and other liver diseases are ‘preventable’, meaning death can be avoided by public health interventions in the broadest sense. As hepatitis C is curable and as such the only liver disease deemed amenable to intervention, addressing hepatitis C will be crucial in efforts to achieve a reduction in mortality from liver disease.

The inclusion of under-75 mortality rate from liver disease within the Commissioning Outcomes Framework means commissioners at clinical commissioning group level will have a major role to play in ensuring that services are commissioned that focus on the identification of people with, and those at risk of contracting, hepatitis C. Hepatitis C is included within four of the five domains in the NHS Outcomes Framework 2012/13 Technical Appendix.

The Public Health Outcomes Framework shares this outcome on reducing the under-75 mortality rate from liver disease. The working draft of the Guidance to Support the Provision of Healthcare Public Health Advice to Clinical Commissioning Groups for Directors of Public Health highlights in its appendix the importance of protection functions including blood borne virus prevention and case identification for hepatitis C and other blood borne viruses. To reduce the transmission of hepatitis C it is crucial that Directors of Public Health are aware of the importance of screening programmes and education.

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