It's time for action: How WithYou is leading the fight against hepatitis C

Hepatitis claims a life every 30 seconds. Globally, more than 300 million people are living with hepatitis, and more than 1.3 million lives are lost each year to hepatitis B and C. Yet, we have the tools to eliminate the disease by 2030.*

This World Hepatitis Day, let’s raise our collective voices for those affected by hepatitis. With only six years left to meet the global goal of eliminating hepatitis by 2030, it’s time for action.

What is hepatitis?

Hepatitis is a general term for inflammation of the liver. Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus (HIV) are the blood-borne viruses we test for. Hepatitis C can cause life-threatening liver disease, including cancer, and often shows no symptoms until the liver is severely damaged. 

Test, treat, repeat

Over the last few years, WithYou has achieved some fantastic results in our mission to micro-eliminate hepatitis C. We’ve undertaken a concerted effort to expand testing, raise awareness, and provide life-saving treatment to those affected by the virus. 

A cornerstone of our approach is the 'opt-out' testing policy. Every person who engages with our services, whether they inject or not, is offered a dry blood spot test (DBST) - a simple and effective finger-prick test that screens for hepatitis B, hepatitis C, and HIV. This strategy helps reduce stigma and ensures that everyone is tested, regardless of their disclosed risk factors or substance use history.

Whilst the micro-elimination approach enables us to focus our efforts on the high-risk areas, our ethos from the beginning has been to normalise testing and embed it as part of core services. We’re fortunate to have champions and leads that drive our testing and progress towards elimination, but we firmly believe it cannot sit with one team. The magic happens when it becomes a collective responsibility, embraced and understood at every level. 

Leading the way in testing and treatment

One of our key leaders in this cultural shift towards testing and treatment is Helen Hampton, a Queen's Nurse, National BBV Lead, and Clinical Lead in Cornwall. 

Helen embodies the collaborative and community-focused spirit of WithYou. Her role involves not only clinical leadership but also forging strategic partnerships with external agencies, including the Hepatitis C Trust and the South West Peninsula Operational Delivery Network. These collaborations are crucial in delivering seamless care, from initial testing to successful treatment.

Helen’s perspective on our efforts underscores the importance of working together: 

We need to work as a team; we can’t work in isolation. In-house collaboration with trusts, peer leads and volunteers, community vans, and hepatology colleagues is essential. We meet clients where they are, be it an office, GP surgery, town hall, tent, or on the street, to ensure they receive timely assessments and treatment. 

Bringing treatment into drug services is key for clients to follow through on treatment, as it’s the familiar face the client knows already. Stigma can act as a barrier to attending a medical setting, and clients also report poor access to transport links, hospital phobia and unstable housing as the main reasons for not attending hospital appointments.

A flexible client-focussed model is vital to success. We regularly travel to client's homes as well as crisis accommodation to arrange their hepatitis C treatment, taking a portable fibroscan and medication. I believe if we’re going to eliminate hepatitis C then we need to ensure clients don’t have to jump through hoops to get treated. 

Charting our progress

Our 12 BBV commissioned services are doing vital work and are making progress towards achieving our goal of micro elimination. Several of our services have now achieved micro-elimination, and the others are very close:

• Bournemouth, Christchurch and Poole
• Cornwall
• Darlington - achieved micro-elimination in September 2023 and has maintained at the 6 month review
• Liverpool - achieved micro-elimination in January 2024 and has maintained at the 6 month review
• North East Lincolnshire (Grimsby)
• North Lincolnshire (Scunthorpe) - achieved micro-elimination in October 2023 and has maintained at the 6 month review
• North Somerset
• Redcar and Cleveland
• Rotherham
• Shropshire - achieved micro-elimination in December 2023 and has maintained at the 6 month review
• Wigan and Leigh

It’s time for action, together

Back in 2007 when I started, it wasn’t simple. There were no DBST, only venous bloods. Treatment was interferon, akin to chemotherapy, and we needed to send people for liver biopsies. The journey was long for patients — between 6 to 12 months of treatment depending on genotype — and they had to be monitored for side effects. Whereas now, it is tablet-based, shorter in duration, and has very minimal side effects. We have treatment at our fingertips, it's time to take action and use it.

Eliminating hepatitis C requires collective action. This World Hepatitis Day, support hepatitis C awareness and elimination efforts. Get tested, advocate for more resources, and help reduce stigma. With the dedication of professionals like Helen and community support, we are on the path to a hepatitis-free future.

WithYou is working in partnership with Gilead Sciences and NHSE as part of the National Elimination Programme. We thank them for their continued support as we work together to eliminate hepatitis C.