Experts rally to get European commitment to halting the hepatitis B and C epidemic

Experts rally to get European commitment to halting the hepatitis B and C epidemic Brussels, Friday, 15 October 2010, 12.00 noon CET: In an unprecedented move to address the public health threat that viral hepatitis represents across the European Union (EU), leading physicians, scientists and patient groups demanded policy action(1) from EU officials at today's Summit Conference on Hepatitis B and C. New research highlights how Member States are failing to consistently implement prevention, screening, surveillance and early treatment programmes that would help to halt the epidemic. (2,3)

At least 23 million people are estimated to be living with chronic hepatitis B and C, but data available show that this does not reflect the true burden of this life-threatening health issue.(4) consequences of viral hepatitis, if left untreated, are severe and potentially fatal. Liver cancer related deaths, which are attributed to chronic infection with viral hepatitis B or C in up to 85 percent of the cases,(5) have increased significantly over the past two decades in Europe.(6)

A co-chair of the Partnership Steering Group, Professor Massimo Colombo of the University of Milan, Italy said: "Throughout the conference, presentations have shown that we have the knowledge and tools available with prevention, screening and effective treatments to manage the problem and that these can be put into place. It was our mission to bring together the right scientific and patient-centric expertise with a single-minded determination to find solutions to combat these devastating diseases. Now we must work towards developing and implementing integrated European policies that can stop this hepatitis B and C timebomb."

Ultimately, inadequate prevention through public awareness and screening, as well as a lack of early diagnosis protocols are the key barriers to effectively managing viral hepatitis. For example, across Europe challenges around diagnosis are linked to the lack of training amongst general practitioners to recognise the early symptoms of liver disease.iii For hepatitis B, vaccination for children has been effectively implemented across most Member States, but considerable efforts still need to be made to capture age-groups that preceded the introduction of these immunization programmes. Most notably in secondary prevention, significant gaps remain in the systematic implementation of government-led programmes that drive effective screening in a sustainable and comprehensive way - only France and Scotland have these in place.

Highlights from the latest research include a report from the European Centre for Disease Prevention and Control (ECDC) which concluded that better surveillance and monitoring activities, further research, and realistic studies on costs are needed to provide the information basis for rational policy making on future secondary prevention of hepatitis B and hepatitis C infection in the EU and its neighbourhood.(2) Building on these findings, the International Centre for Migration Health and Development presented evidence that there are clear benefits for prevention programmes to be implemented within the EU to reach at-risk populations. Plans should include better coordination and coverage with vaccination against hepatitis B plus education, surveillance and screening programmes to address the challenges of infectious disease like viral hepatitis, when populations from endemic zones relocate to and across Europe. (7)

Nadine Piorkowsky, President of the European Liver Patients Association (ELPA) and co-chair of the Partnership Steering Group, stated: "In response to our Call to Action, we expect the European Institutions will develop concrete proposals; a Council Recommendation on viral hepatitis B and C screening of risk groups would be a powerful tool to start with. We need to see momentum on this public health priority, and quickly. Our work is only just starting and we have a long way to go, but there is now commitment to a way forward and we will see the results so greatly needed."

The Call to Action,(1) based on studies and best practice from a number of existing programmes from Member States has the backing of major stakeholders and supporters involved in the Partnership and seeks to improve awareness and prevention, diagnosis and treatment of hepatitis B and C. It calls for policy solutions to: develop and accelerate EU-wide surveillance through co-ordinated programmes; promote universal access to early treatment; improve public awareness on the risks and to integrate prevention programmes into existing public health frameworks; establish cost-effective and targeted screening programmes for at-risk populations and to expand research resources in hepatitis B and C.

About the conference
The Conference runs from midday on Thursday 14th October until the early afternoon of Friday 15th October. The Conference programme will be presented in 5 sessions over these two days.

Contributions from the European Institutions came from DG SANCO, DG RESEARCH and Alojz Peterle MEP. A keynote speech was given by Dr. Nedret Emiroglu of the Division of Non-communicable Diseases and Health Promotion WHO-Europe.

The Conference is held under the auspices of the current Belgian EU Presidency.

About the Partnership
Leading European scientists, professors, public health experts and patient advocates have joined in a Steering Group responsible for the management and delivery of the Hepatitis B and C Summit Conference and its associated programme.

The Co-Chairs of the Steering Group are as follow:
Prof. Angelos Hatzakis
Professor of Epidemiology and Preventive Medicine
Director, Department of Hygiene, Epidemiology & Medical Statistics
Athens University Medical School

Nadine Piorkowsky
President, European Liver Patients Association

Prof. Massimo Colombo
Chairman, 1st Division of Gastroenterology
Fondazione IRCCS Maggiore Hospital Policlinico, Mangiagalli e Regina Elena
University of Milan

The new Partnership involves the European Liver Patients Association (ELPA), the European Association for the Study of the Liver (EASL), the World Hepatitis Alliance (WHA), and the International Centre for Migration, Health and Development (ICMHD). Other associates include the Viral Hepatitis Prevention Board (VHPB), and the European Centre for Disease Prevention and Control (ECDC).

For more details on the conference and the full list of members of the Steering Group visit:

1. Call to Action. Presented at the Hepatitis B and C Summit Conference in Brussels on 15/10/2010.
2. European Centre for Disease Prevention and Control. Surveillance and prevention of hepatitis B and C in Europe. Stockholm, October 2010
3. Hepatitis Patient Self-Help in Europe. European Liver Patient Association. September 2010
4. Piorkowsky N Y. Europe’s hepatitis challenge: defusing the "viral timebomb". Journal of Hepatology 51 (2009) 1068
5. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006;45:529--38.
6. McGlynn KA, Tsao L, Hsing AW, et al. International trends and patterns of primary liver cancer. Int J Cancer. 2001;94:290-296
7. Carballo M, Cody R, O’Reilly E. Migration, Hepatitis B and Hepatitis C. International Centre for Migration, Health and Development. October 2010.