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Changes to the national strategies, plans and guidelines for
                the treatment of hepatitis C in people who inject drugs between
                2013 and 2016: a cross-sectional survey of 34 European
                countries

# metadata.dc.description.abstract[].value
Background: Hepatitis C virus (HCV) infection is the leading cause of cirrhosis, end-stage liver disease and
hepatocellular carcinoma (HCC) worldwide. In Europe, people who inject drugs (PWID) represent the majority of
HCV infections, but are often excluded from treatment. The aim of this study was to report on national HCV
strategies, action plans and guidelines in European countries that include HCV treatment for the general population
as well as for PWID. Data on access to direct-acting antivirals (DAAs) were also collected.
Methods: In 2016, 38 non-governmental organisations, universities and public health institutions that work with
PWID in 34 European countries were invited to complete a 16-item online survey about current national HCV
treatment policies and guidelines. Data from 2016 were compared to those from 2013 for 33 European countries,
and time trends are presented. Differences in the data were analysed. Data from 2016 on general access to DAAs in
PWID are presented separately.
Results: The response rate was 100%. Fourteen countries (42%) reported having a national HCV strategy covering
HCV treatment; 12 of these addressed HCV treatment for PWID. Respondents from ten countries (29%) reported
having a national HCV action plan. PWID were specifically included in seven of them. Twenty-nine countries (85%)
reported having national HCV treatment guidelines. PWID were specifically included in 23 (79%) of them. Compared
to 2013, respondents reported that an additional seven countries (25%) had national strategies, an additional eight
countries (29%) had action plans and an additional six countries (19%) had HCV treatment guidelines. However,
PWID were not included in two, four and six of those countries, respectively. DAAs were reported to be available in
91% of the study countries, with restrictions reported in 71% of them.
Conclusion: Respondents reported that fewer than half of the European countries in this study had a national HCV
strategy and/or action plan, with even fewer including PWID. However, when compared to 2013, the number of
such countries had slightly increased. Although PWID are often addressed in clinical guidelines, strategic action is
needed to increase access to HCV treatment for this group and the situation should be regularly monitored.

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Harm Reduction Journal, 2019, vol. 16, num. 32

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Changes to the national strategies, plans and guidelines for
                the treatment of hepatitis C in people who inject drugs between
                2013 and 2016: a cross-sectional survey of 34 European
                countries