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Health Strategy on HCV in The Netherlands. V H PB meeting May 200 2. van Hattum. Health Strategy on HCV in The Netherlands. V H PB meeting May 200 2. epidemiology observations recommendations. HCV in The Netherlands Epidemiology. HCV in The Netherlands Epidemiology.

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health strategy on hcv in the netherlands

Health Strategy on HCVinThe Netherlands

VHPB meetingMay 2002

van Hattum

health strategy on hcv in the netherlands1

Health Strategy on HCVinThe Netherlands

VHPB meetingMay 2002

  • epidemiology
  • observations
  • recommendations
hcv in the netherlands epidemiology1

HCV in The NetherlandsEpidemiology

  • prevalence in the general population
  • new blood donors: 0.04 %
    • estimated in general population: 5-10x
  • blood donors 1984-1990: <0.2 %
  • general population (low risk profile):0.1 %
  • general population (extrapolated):<0.4 %

HCV observed in “random” population: 0.3-0.4 %

hcv in the netherlands epidemiology2

HCV in The NetherlandsEpidemiology

  • prevalence in recipients of blood products
  • haemophiliacs (81 %) 1150
  • haemodialysis (2.7 %) 110
  • blood transfusions (est.) 13500
  • ~ 0.1 % of general population
hcv in the netherlands epidemiology3

HCV in The NetherlandsEpidemiology

  • prevalence, other groups
  • ivd users (75 %) 12000
  • allochtonous (1 - 2.5 %) <25000
  • ~ 0.2 % of general population
  • hospital infection, needle stick, transplantation, dentist
  • household, perinatal, sexual, tattoo/piercing
hcv in the netherlands epidemiology4

HCV in The NetherlandsEpidemiology

prevalence

General population

HCV observed in “random” population: 0.3-0.4 %

Risk groups

recipients of blood products 0.1 %

ivd users 0.08 %

allochtonous 0.15 %

risky behaviour <0.1 %

+ 0.4 %

~ 60 000 people, where are they ?

hcv in the netherlands basic facts

HCV in The NetherlandsBasic Facts

Minister of Health, Welfare and Sports

Health Council of the Netherlands

  • chronic hepatitis C is a serious disease
  • hepatitis C virus can be detected with great accuracy
  • hep C is aggravated by hep A, hep B, HIV or alcohol
  • treatment is available and may result in elimination of
  • the HCV and cure
hcv in the netherlands basic facts1

HCV in The NetherlandsBasic Facts

Minister of Health, Welfare and Sports

Health Council of the Netherlands

  • overall prevalence is considered to be comparable to
  • other countries in Northern Europe
  • most prevalent risk groups:
  • people who have used intravenous drugs
  • recipients of blood products
  • allochtonous descent
  • general or focused screening programs to detect
  • sporadic HC patients seem inefficient
hcv in the netherlands basic facts2

HCV in The NetherlandsBasic Facts

Minister of Health, Welfare and Sports

Health Council of the Netherlands

  • HCV is transmitted mainly via blood or blood products
  • hygienic measures among non-regular practitioners
  • (tattoo, piercing, acupuncture, ritual) are unclear
hcv in the netherlands basic facts3

HCV in The NetherlandsBasic Facts

Minister of Health, Welfare and Sport

Health Council of the Netherlands

  • it is the patients’ right that physicians provide them
  • spontaneously with relevant information
  • the general population lacks adequate knowledge
  • about HCV, the transmission routes, the disease
  • and possible treatment
  • this prevents them from taking responsibility for their
  • own health
hcv in the netherlands recommendations

HCV in The NetherlandsRecommendations

Minister of Health, Welfare and Sport

Health Council of the Netherlands

  • a general look back, i.e. tracing and testing all people
  • possibly at risk in the past would be inefficient
  • hospitals should keep precise records of the origin
  • and use of blood products
  • epidemiological research is required as to the
  • prevalence of HCV infection in the various population groups
        • children of HCV positive mothers
        • first generation of allochtonousdescent
hcv in the netherlands recommendations1

HCV in The NetherlandsRecommendations

Minister of Health, Welfare and Sport

Health Council of the Netherlands

  • tracing and treating patients with conditions that go
  • along with increased likelihood of HCV infection
        • haemophiliacs
        • haemodialysis patients
        • polytransfusees
        • patients with organ transplants
        • patients with puncture wounds
  • patients with hep C must be advised to stop alcohol
hcv in the netherlands recommendations2

HCV in The NetherlandsRecommendations

Minister of Health, Welfare and Sport

Health Council of the Netherlands

  • medical doctors of various disciplines must be
  • trained on diagnostics and advising patients
  • professionals involved in increased risk of HCV
  • transmission must be informed on hygiene
        • hairdressers
        • chiropodists
        • acupuncturists
        • piercing / tattoo practitioners
        • ritual practitioners
hcv in the netherlands recommendations3

HCV in The NetherlandsRecommendations

Minister of Health, Welfare and Sport

Health Council of the Netherlands

  • information to the general population
      • the disease
      • the transmission
      • the possibility to treat
  • goal-oriented information to people in risk groups
      • seek medical care
      • if necessary, receive treatment
      • Immigrants should be informed through their own channels
      • intermediaries should be trained for that purpose
hcv in the netherlands

HCV in The Netherlands

Hepatitis C Surveillance study

1999/2000

mixed population, 1.5 million, 1.5 year

78 new hepatitis C patients diagnosed

19 referred to internist / gastroenterologist

3 treated with IFN + ribavirin

current situation

  • active awareness programs in risk groups
  • training courses to professionals
      • in cooperation with the various professional societies
      • special aspects concerning each professional group
      • aiming at hygienic measures
      • providing information to clients / patients
      • diagnosing new patients
      • providing treatment
hcv in the netherlands1

HCV in The Netherlands

current situation

HC treatment of (ex) i.v. drug users

starting up nation wide

pilot study: - feasible

if using infrastructure of drug user control programs

if the present staff is trained

- good compliance

IFN 6 months, 56 patients, 2 dropouts

In NL most drug addicts are registered in programs

everybody has a (mandatory) health insurance

HC treatment (IFN+riba) is available and refundable

  • active awareness programs in risk groups
  • training courses to professionals
      • in cooperation with the various professional societies
      • special aspects concerning each professional group
      • aiming at hygienic measures
      • providing information to clients / patients
      • diagnosing new patients
      • providing treatment
  • special treatment programs of risk groups
health strategy on hcv in the netherlands2

Health Strategy onHCV in The Netherlands

summary

  • collect data on epidemiology and support research
  • improve the awareness of the disease and hygiene
      • general population
      • risk groups
  • improve recognition of the disease and hygiene
      • by non-medical practitioners
      • by medical professionals
  • improve treatment of the disease
      • stimulate referral: non-medical, general practitioner, specialist
      • stimulate adequate treatment by the specialists
      • support treatment programmes for risk groups
health strategy on hcv in the netherlands3

Health Strategy on HCVinThe Netherlands

VHPB meetingMay 2002

van Hattum end

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