SAN DIEGO, CA- With liver disease the second leading killer of people living with HIV and one in every six HIV-positive people in resource-poor settings co-infected with Hepatitis B, efforts to increase awareness, screening, prevention, treatment access and research of effective treatments are needed, Dr. Chloe Thio told an audience at ID Week, this morning.
Part of a symposium on approaches to care for patients with HIV and Hepatitis coinfection, her talk addressed conditions in countries where HIV rates are high, access to care challenged, and the cost of existing treatments keeps them out of reach.
In a survey of 193 countries, 80 percent of those responding identified hepatitis as an urgent public health problem — with nearly 100 percent of African countries regarded the problem as urgent.
Lack of public awareness, stigma were among the challenges reported. Only 4 percent of populations in resource limited settings live in areas where testing is accessible. At the same time the risks are high, Thio said, with 23 million new hepatitis B and hepatitis C infections worldwide, about 6.7 billion unsafe injections are administered in resource limited settings. In 2004 22 percent of African countries did not screen blood donations. Vaccines for hepatitis B are available for infants but only one country has a policy making the vaccines available for people with HIV or other chronic conditions. Lack of funding makes vaccines inaccessible to pregnant women who can pass the virus to their infants.
At the same time, rates of hepatitis can vary widely across countries and prevalence data that can guide the use of limited resources remains scarce. And determining what medicines can be safely used in settings where patients may run less risk of resistance could make better use of treatment budgets. In the meantime, Thio said, immediate steps include vaccinating HIV-positive patients against hepatitis B, screening HIV-positive patients for HIV, stepping up efforts to prevent mother to infant transmission.