HCV - The burden of disease; the possibility of cure

Portugal, late 70’s early 80’s – a small group of pioneers hold a conviction that impelled them to action – as a result, policies followed practices and nowadays a nationwide public multidisciplinary organization is dedicated to the goal of treating addiction in parity with any other physical or mental disease.

Against all odds, an historical document, “Estratégia Nacional”, the core to the global approach – prevention, treatment, social rehabilitation, harm reduction - and also the support for the 2001 Decriminalization Act, emerged.

Addiction research and treatment modalities have evolve so much over the past few years, as has the treatment of comorbid infectious diseases, namely HIV and HCV, a public health concern of the 21st century.

In the WHO European Region, people who inject drugs (PWID) are at highest risk of acquiring HCV; 14 million are estimated to be chronically infected and many of them may not be aware.

112.500 people die due to HCV - related liver disease each year.

The care and cure trail of this Portuguese model links addiction care units, harm reduction structures, GP’s and hospital specialists so that the best clinical approach, the best available care can be provided to the patients we mutually serve – this is an ethical imperative.

Comorbidity with mental disorders should also be acknowledged, since the prevalence amongst drug users is higher.

Portugal, July 2017: a total of 17.591 patients are referred to HCV treatment; 6639 meet the criteria of cure. This is the result, until now, of breaking barriers to care on the treatment-setting level we will describe.

However, there’s still a lot of ground to cover, and the implementation of safe injections places and the Fast-track Cities project represent a breakthrough, hence it’s known the transmission of the infection is now mainly concentrated in PWID.