A consortium of partners is undertaking a viral hepatitis service provision and research project for key populations (people who inject drugs, sex workers and men who have sex with men) in South Africa. The study will assess information gaps on populations disproportionately affected by viral hepatitis and provide an evidence base to guide future interventions.
Hepatitis B and hepatitis C are infectious diseases that affect the liver. They are usually without symptoms for many years. This means that those infected are infectious without even knowing it and can silently develop progressive liver damage. This year the World Health Organisation (WHO) released the first ever Global Strategy for Viral Hepatitis. The strategy aims to eliminate viral hepatitis as a public health threat by 2030.
People who inject drugs, sex workers and men who have sex with men are at higher risk of contracting viral hepatitis B and C. Viral hepatitis is a particular concern in a context of high HIV prevalence because co-infection can result in more rapid progression of both diseases.
At present viral hepatitis services for “key populations” are limited in South Africa and there is very little information on prevalence levels, though studies that have been done indicate that rates are high in key population groups. The forthcoming study is funded by the Bristol-Myers Squibb Foundation Secure the Future, and implemented by TB/HIV Care Association, in partnership with the University of Cape Town, Anova Health Institute, the National Institute for Communicable Diseases and OUT Wellbeing.
Spanning seven cities – Cape Town, Johannesburg, Pretoria, Mthatha, Pietermaritzburg, Port Elizabeth and Durban – the study builds on already occurring service delivery processes.
Hepatitis B and C diagnosis usually require expensive and time-consuming laboratory activities. In this study, participants will be tested for HIV, hepatitis B and C at service delivery sites. The point-of-care (‘rapid’) hepatitis C testing will be done in a variety of ways, and the results will be compared to standard laboratory tests. This will indicate whether inexpensive rapid test mechanisms can be reliably used in the South African context. If this proves to be the case, it opens up new possibilities for making hepatitis testing a common part of health screening processes.
The study’s results will provide an evidence base to support national efforts to reach the WHO 2030 target of reducing the public health threat of viral hepatitis to zero.