Dáil Éireann Debate, Wednesday - 21 April 2021
1667. Deputy David Cullinane asked the Minister for Health the latest estimate of the number of patients living with hepatitis C in the State for each of the past five years; the progress made towards making hepatitis C a rare disease; the targets that must be met to reach the 2030 elimination target; his plans to reverse the trend in decreasing numbers availing for treatment; and if he will make a statement on the matter. [18600/21]
View answer1668. Deputy David Cullinane asked the Minister for Health if he is developing a hepatitis C treatment programme strategy; and if he will make a statement on the matter. [18601/21]
View answerI propose to take Questions Nos. 1667 and 1668 together.
The HSE established a National Hepatitis C Treatment Programme (NHCTP) in 2015 and began the process of providing treatment for Hepatitis C using Directly Acting Antivirals (DAA’s) to patients prioritised according to clinical need. The HSE in its National Service Plans has committed to the continued implementation of a multi annual public health plan for the therapeutic treatment of hepatitis C. The NHCTP goal is to make hepatitis C a rare disease in Ireland by 2026. In order to achieve this, the Programme is allocated funding of €25m each year by my Department.
In 2014 studies indicated that Ireland had a prevalence of 20,000-30,000. However, this is an estimate of the prevalence and the true prevalence rate in Ireland is unknown. There is no general screening of the population to determine prevalence rates. To date, a national sero-prevalence study has not been undertaken. However, the NHCTP has observed a marked decline in numbers of newly diagnosed infections in recent years and a significant increase in the numbers of patients successfully completing treatment which suggests that the treatment as prevention may be working.
The NHCTP aims to make hepatitis C a rare disease in Ireland and to achieve the WHO elimination targets. Achieving this will require identification and treatment of the majority of chronically infected individuals in the community. In this regard the NHCTP are currently engaged in a formal epidemiological study to determine the prevalence and to facilitate informed decisions regarding screening. This study has received ethical approval and commenced in St. Vincent's hospital. It is currently submitted for ethical approval in a number of hospitals throughout the country with the aim of getting a robust national prevalence figure.
In relation to plans to reverse the trend in decreasing numbers availing of treatment, it should be noted that with the outbreak of COVID-19 hepatitis C clinics were significantly impacted. However, clinics are returning to normal and the NHCTP is confident that the programme is on target to make hepatitis C a rare disease in Ireland by 2026, and in alignment with the WHO goal, to fully eliminate the disease in Ireland by 2030.
To year end 2020 the total number of cases of registrations in the National Hepatitis C Disease Registry (NHCDR) is 6,695 with treatment uptake rates close to or in excess of 90% of all cases registered with the NHCDR annually. Treatment provided is by the use of DAA medication with cure rates in excess of 95%.
The HSE is committed to the evolving needs in treating hepatitis C patients, these include screening, testing, integration of treatment etc. and not just simply provision of treatment - case finding and implementing national hepatitis C screening guidelines are key. To ensure that the NHCTP meets the WHO elimination target the NHCTP has implemented the following:
1. The Community Prescribing Project
2. The Irish Prison Service Treatment Programme
3. Extending the Seek and Treat Approach to the People who are non-methadone dependant
A programme of work to refresh the National Hepatitis C Treatment Programme Strategy and Planning Document 2020-2026 is nearing completion. This will set a clear direction for the further expansion of the programme.
