Hepatitis C micro-eliminated in Trafford
Drug and alcohol recovery services run by Greater Manchester Mental Health NHS Foundation Trust (GMMH) have ‘micro eliminated’ Hepatitis C in Trafford.
All GMMH’s service users in the area, who access their Achieve Recovery Services, have been offered a test for the virus with 99.24% of people with a history of injecting being tested and 191 people being tested in the past year.
Of those, 90.91% have been tested in the last 12 months with 100% of those who were tested positive being referred for treatment. Of those referrals, 94.38% of those have had Hepatitis C treatment.
It is the second time in less than eight months that GMMH’s Achieve Recovery Services have managed such a feat in one of their service areas, with Bury recording similar status last June 2024.
In Trafford, this potentially life-saving work has been accomplished after years of partnership working to make sure that all who are at risk of Hepatitis C in the area and beyond are tested and treated for the condition.
Service managers say excellent progress is also being made to realise their ambition of micro-eliminating the virus in Salford and Bolton too.
Hepatitis C is a blood borne virus which can affect the liver. Symptoms can range in severity, but if left untreated it can cause the liver to stop working properly and result in serious liver damage, including liver cancer.
It often has no symptoms and can be passed from person to person via exposure to infected blood.
One of the main ways the virus is spread is by sharing drug-using paraphernalia such as injecting equipment - meaning people accessing addictions services have an increased risk of infection.
People can also be vulnerable to hepatitis C if they have had unprotected sex, have used unsterile equipment for tattoos, accessed medical or dental treatment abroad in unsterile conditions, or if they have had blood transfusion prior to 1996.
It is estimated that globally, 58 million people have an active hepatitis C viral infection, and there are around 1.5 million new infections each year. While there is currently no effective vaccine for prevention, antiviral medicines have a cure rate of over 95%.
The World Health Organisation has committed to achieving Hepatitis C virus elimination globally by 2030; and NHS England (NHSE) has set a target to eliminate Hepatitis C in England ahead of 2030, predominantly through ‘micro-elimination’, meaning elimination in defined populations.
To measure progress towards micro-elimination across England, a forum made up of Drug and Alcohol Providers, NHSE, Hepatitis C Trust and Gilead Sciences co-developed a definition and quality standards for micro-elimination. They defined it as:
· 100% of people in structured treatment for addictions or substance misuse are offered a hepatitis C test.
· 100% of people with a history of injecting have been tested for hepatitis C
· 90% of people with a history of injecting who might still be at risk have a Hepatitis C test date within the last 12 months.
· 90% of people who’ve tested positive for hepatitis have started or completed treatment.
Achieve Recovery Services is the lead provider community addictions services in the boroughs of Bury, Bolton, Salford and Trafford. In 2021, alongside its partner agencies and stakeholders, Achieve developed a plan to micro-eliminate Hepatitis C across these boroughs by 2030.
This work has been supported by funding from Hep C U Later (run by Midlands Partnership University NHS Foundation Trust), the Office for Health Inequalities and Disparities, and local authority commissioners.
It involves several local initiatives and programmes to test and treat those at risk, including those in contact with drug and alcohol services, their family and friends, and the wider public.
Blood borne virus (BBV) testing is offered through a programme of test and treat events, drop ins, needle exchange points, structured appointments, and outreach appointments.
Specialist harm reduction advice is also provided to reduce risks and help stop the spread of infections.
For those who test positive, treatment is offered by specialist clinicians via North Manchester Hospital, by Manchester University NHS Foundation Trust. This can be delivered at local Achieve sites, where people often feel most comfortable.
Those affected can also be referred to specialist liver clinics for ongoing physical support, if needed.
In Trafford, one service user Wayne, who was referred to Achieve Trafford for Hepatitis C testing and went on to receive treatment, said:
“The testing is a good thing because people can be diagnosed and get treated. Rather than getting unwell and dying an early death.
“Now I don’t have to worry about Hep C. I know that I am cured and won’t suffer any harm from Hep C. I had a fibroscan which told me about my liver health, and I am pleased that being treated has prevented any damage to my liver from the virus.
“It’s very important you get tested, it is vital. Achieve helps people to get tested and treated and has allayed my fears about the Hep C treatment. I was supported the whole way through the treatment.
“I didn't have any fears about being tested, as I was always very careful with my intravenous drug use practices. I was tested after an accident I had abroad. I was open with my partner and close contacts about my diagnosis. I was worried that they might get it too, so had a lot of worry about that and had to take precautions to protect others from getting Hep C from me.
“Now that I am cured, I don't have to worry about my health, or about Hep C harming my liver or causing me to die early. Plus, I don't have the fears of transmitting it to others.”
Jennie Yates, Harm Reduction Lead for Achieve Salford and Trafford, said:
“You cannot over-estimate the importance of getting people tested for Hepatitis C and at Achieve we offer Hep C testing to all clients. We encourage everyone to get tested at least once. Achieve also gives advice on blood borne virus risk factors and advice on how to protect yourself from getting Hep C. We provide a range of harm reduction interventions, free condoms and needle exchange services at Achieve bases.
“This is the concerted, on-going effort of the Achieve teams to help reduce the harm caused by Hep C and our work in promoting the health and well-being of people who access Achieve services.
“We are really pleased and proud of what we have accomplished and this will undoubtedly have saved lives and helped give our service users a healthier and brighter future.”
If you or someone you know could be at risk of Hepatitis C, help is available. You can visit www.gmmh.nhs.uk/achieve to find out more about the support in your area, or email us at achieve.referrals@gmmh.nhs.uk. Or, you can contact the Hepatitis C Trust helpline on 020 7089 6221. You can also access a free at home test kit for hep C by visiting www.hepculater.com or https://hepctest.nhs.uk/ref/cul.
