IAS 2019: Mexico City

TB HIV Care was well represented at the 10th IAS Conference on HIV Science, which took place from 21 July to 24 July 2019 in Mexico City, Mexico.

The IAS Conference on HIV Science is the world’s most influential meeting on HIV research and features diverse topics, speakers and cutting-edge studies.

TB HIV Care’s Prof. Harry Hausler presented on isoniazid preventive therapy (IPT) among key populations at a TB and HIV satellite session, while Dr Andrew Scheibe participated in an HIV and viral hepatitis pre-conference session – as well as sharing findings of South Africa’s harm reduction coverage and gaps in an oral presentation (see article below).

TB HIV Care also had several meetings and engagements with partners, including UNITE, GNP+ and others.

TB HIV Care’s harm reduction work received media coverage, and you can read the article here:
Low harm reduction coverage for people who inject drugs in South Africa

World Hepatitis Day Provincial Events

Funded by the Bristol-Myers Squibb Foundation, The viral hepatitis C initiative for key populations in South Africa is a cross-sectional study led by TB HIV Care, in partnership with Anova Health Institute, OUT Well-being, The National Institute for Communicable Diseases and the Division of Hepatology at the University of Cape Town.

Study findings are now being disseminated at World Hepatitis Day Provincial Events, which TB HIV Care is hosting in collaboration with the National Department of Health. The events, taking place in Durban, Cape Town, East London and Pretoria, will:

  • Share updates on the draft South African National Viral Hepatitis Guidelines and South African Hepatitis Action Plan
  • Share study findings of the viral hepatitis initiative among key populations in South Africa: prevalence data and the utility of various HCV testing options
  • Discuss experiences and challenges around HBV and HCV prevention and treatment in South Africa
  • Discuss plans to move towards the elimination of viral hepatitis in South Africa

The first event took place in Durban on Wednesday, 11 July. We had a fantastic turn-out, including representatives from the NDOH, KZN DOH, UKZN, staff from Inkosi Albert Luthuli Central Hospital and Grey’s Hospital, Ethekwini DOH, CDC, Abbot, Cepheid and BMSF. The Deputy Mayor also attended and said a few words at the event.

The various presentations, including the study findings, were well received. A panel discussion with people who inject drugs (PWID) was particularly impactful as it gave a very ‘human’ and emotional  perspective from people living with hepatitis.

The event made the evening news. To watch the SABC clip, click here.

The second event took place in Cape Town on Thursday, 19 July. We hosted the event at our Cape Town Drop-in Centre and welcomed guests from the NDOH, Western Cape DOH, CDC Atlanta and various partners.

The evening included presentations by Katherine Young (Strategic Information and Research Manager), Neliswa Gogela (UCT Division of Hepatology), Charles Mugero (NDoH) and Kevin Rebe (Anova Health Institute representative), but it was once again the panel discussion with people who inject drugs (PWID) that proved to be the highlight of the event. Hearing personal accounts from people living with hepatitis is extremely powerful.

The hepatitis ‘roadshow’ continues in East London on the 3rd of August and in Pretoria on the 14th of August.

For more information, please contact linsey@tbhivcare.org.

Interim study results show ‘concerning’ levels of hepatitis C among groups most at risk

Friday the 28th July will mark World Hepatitis Day. Hepatitis B is endemic in South Africa, but up until now, little has been known about the local prevalence of hepatitis C, especially in high-risk populations such as men who have sex with men, sex workers and people who use drugs. Today an ongoing study has released preliminary results. These raise concerns over hepatitis C prevalence among certain groups.

High prevalence makes affordable treatment an urgent priority

“I don’t think anyone was expecting to see the kind of prevalence we’ve seen so far with 54% of people who use drugs testing positive for hepatitis C, and in some areas, up to 77% testing positive. This underscores the urgency for us to explore affordable treatment options as soon as possible,’ says Dr Andrew Scheibe, one of the researchers working with TB/HIV Care Association (TB/HIV Care) on this project.

Although hepatitis C is curable, the cost of current treatment puts it out of reach for many. There is a vaccine for hepatitis B, but it is not readily available for adults through the public health system.

Viral hepatitis is a public health threat worldwide, but a particular danger in South Africa because of the high prevalence of HIV.

Hepatitis B and hepatitis C are infectious diseases that affect the liver. Those who are infected can silently develop progressive liver damage and can unknowingly be infectious.

A life-threatening disease, viral hepatitis is a particular concern in regions with a high HIV prevalence regions, such as South Africa, because co-infection can result in more rapid progression of both diseases.

The World Health Organization (WHO) estimates that globally 150 million people are infected with hepatitis C and that the disease causes half a million deaths a year. Last year the WHO released the first Global Strategy for Viral Hepatitis. This aims to eliminate viral hepatitis as a public health threat by 2030. South Africa has adopted the same vision.

The early findings of the South African study conducted in seven cities (in Cape Town, Johannesburg, Pretoria, Mthatha, Pietermaritzburg, Port Elizabeth and Durban), put the overall prevalence of hepatitis C among the populations under study (sex workers, men who have sex with men and people who use drugs) at 13%, with the prevalence of hepatitis B at 4%. The study is being implemented by TB/HIV Care, the University of Cape Town, Anova Health Institute, OUT LGBT Wellbeing and the National Institute for Communicable Diseases with funding from the Bristol-Myers Squibb Foundation.

Difficulties in accessing treatment go beyond access to medication

The study has also unearthed disturbing trends relating to treatment. It seems that the difficulties in providing hepatitis C treatment and hepatitis B vaccination may go beyond access to medication alone. Clients who were diagnosed with hepatitis by the study were all referred on for specialist care, but many did not appear for subsequent appointments. The reasons for this are still under study, but early reports suggest that other experiences of discrimination and stigma in the health care system, confusing systems in facilities, the possibilities of a long wait for service and the costs associated with travelling to a different site may all play a role in discouraging clients from continuing care.

Prof. Harry Hausler, the CEO of TB/HIV Care, explains, “Research such as this is critical to understanding the viral hepatitis burden among vulnerable people. Next we will have to work with partners to develop cost-effective ways to provide prevention, screening, diagnosis and treatment services to those who need them, where they need them, and in appropriate ways.”