European HIV-Hepatitis Testing Week 2016: Test. Treat. Prevent.
17 November 2016 - Safe and effective treatments exist that allow people living with HIV and/or viral hepatitis B to lead healthy and long lives. Those living with hepatitis C can be cured. But knowing your health status is the prerequisite to accessing treatment, which is why WHO strongly supports the European HIV-Hepatitis Testing Week. The week aims to break the silence on HIV and viral hepatitis and build momentum to stop these epidemics by 2030.
Nearly half of the 2.5 million people living with HIV in the WHO European Region are currently unaware that they have the infection. Close to half of those who test positive are diagnosed at a late stage of their disease, delaying their access to treatment and increasing the chance of transmission to their partners. The vast majority of the 15 million people living with hepatitis C and 13.3 million people living with hepatitis B in the Region do not know about their infection and are therefore at risk of developing cirrhosis or liver cancer. Currently, on average less than 3% of patients with chronic hepatitis C receive treatment.
Momentum for Europe
This year the HIV-Hepatitis Testing Week comes at a decisive time for the European Region. At their 66th annual meeting, all 53 countries of the Region adopted a new regional action plan on HIV and the first-ever action plan on viral hepatitis. These plans adapt WHO's global HIV and viral hepatitis strategies to political, economic and epidemiological contexts of the Region. They reinforce the ambitious goals of ending the AIDS epidemic and eliminating viral hepatitis as public health threats in the Region by 2030, in line with the Sustainable Development Goal 3 – to ensure healthy lives and promote well-being for all at all ages.
The Action plan for the health sector response to HIV in the WHO European Region outlines ambitious 90-90-90 targets to be achieved by 2020. These include:
- 90% of people living with HIV know their HIV status
- 90% of people diagnosed with HIV receive antiretroviral therapy
- 90% of people receiving antiretroviral therapy achieve viral load suppression
To expand HIV testing, treatment and care, the new action plan recommends that countries:
- provide HIV testing, especially to people at higher risk, in settings with a high number of HIV cases;
- ensure that treatment, care and prevention services immediately follow HIV diagnosis;
- promote rapid HIV testing in ways that are suitable to national contexts, such as testing initiated by health care providers, testing by lay service providers for people at risk through community outreach, testing in closed settings and self-testing;
- adopt a “treat all” approach and update national guidelines on HIV treatment and care to include prevention and management of major co-infections and co-morbidities, particularly sexually-transmitted infections, tuberculosis, hepatitis C and drug dependence; and
- closely monitor antiretroviral treatment (ART) success by implementing regular testing of the HIV viral load and strategies to minimize resistance to HIV drugs, and use the data to inform national policies and guidelines on ART.
Early diagnosis of hepatitis is critical for effective treatment and care. The Action plan for the health sector response to viral hepatitis in the WHO European Region sets the target of diagnosing and treating at least 50% of persons living with chronic hepatitis by 2020. To achieve this, the plan recommends that Member States:
- develop and roll out national viral hepatitis testing guidelines in line with WHO guidance and based on local policies, targeting high risk groups and high risk behaviors;
- offer hepatitis testing as part of a yearly health check-up to all people who use drugs and to all prisoners upon entrance into jail, on an ‘opt-out’ basis;
- strengthen national laboratories to provide quality diagnosis of acute and chronic hepatitis;
- make quality and affordable diagnostics available and accessible, including different testing approaches;
- ensure confidentiality of test results and share results in a way that avoids stigma and links patients to proper care and treatment; and
- train health care workers on viral hepatitis testing and diagnosis.
At the global level, WHO has recently produced:
- guidelines on HIV self-testing and partner notification services, which focus on how these additional approaches can be utilized to achieve the first of the 90- 90-90 targets (to be launched on 1 December 2016); and
- policy brief on guidelines for hepatitis B and C testing, which recommends using different approaches for different populations and different testing strategies.
About European HIV-Hepatitis Testing Week
The European HIV-Hepatitis Testing Week 2016 takes place from 18-25 November. Launched in 2013, the initiative aims to help people become aware of their HIV status. In 2015, the week expanded to include hepatitis. Hepatitis B and C infections are common among people at risk of or living with HIV and these viruses can be transmitted in the same ways as HIV, namely through use of injected drugs and unsafe sex.
European HIV-Hepatitis Testing Week offers partners across the Region the opportunity to come together to advocate for the benefits of early HIV and hepatitis testing among those at risk. In 2015, more than 400 organizations from 49 countries took part in the Week's activities. As a result, thousands of people learnt of their HIV and hepatitis status and are taking action to access treatment and prevention. Nearly 500 organizations are expected to participate in the campaign this year.