Spain is very well positioned to be the first developed country to eradicate the hepatitis C virus, but the home stretch is always the slowest. This viral disease, discovered at the end of the 1980s, can be cured using antiviral drugs since 2015.
Whoever is diagnosed is cured. However, there are still a number of patients who are not on the system’s radar because they do not know that they carry the virus: there are around 20,000, according to data from the Spanish Digestive System Foundation (FEAD). A recent study, published in the journal Lancet Regional Health Europe and referenced by the Ministry of Health, estimates that there are 57,587 people in Spain with an active infection (30% undiagnosed).
The infection caused by the virus – discovered just 30 years ago – damages the body very slowly. It can take a decade or more to irreversibly damage the liver. Thus, the antiviral eliminates the virus but does not cure the organ.
Four deaths linked to hepatitis C occur every week, which are preventable, since treatment cures it in almost 100% of cases.
Javier Garcia-Samaniego
— Head of the Hepatology Department at La Paz Hospital (Madrid)
“A decade after the arrival of antiviral drugs that cure the disease, four deaths occur every week in our country attributable to causes linked to hepatitis C which are preventable, since there is a treatment which cures the disease in practically 100% cases and that.” , if administered early, it can prevent the damage it causes to the liver over the years”, explains Javier García-Samaniego, coordinator of the Alliance for the Elimination of Viral Hepatitis in Spain (AEHVE). and head of the hepatology section of the University Hospital of La Paz (HULP) in Madrid.
Who are they? “People who contracted the infection decades ago and do not know they have it or were not treated at the time,” according to FEAD. In Spain, many people were infected either through blood transfusions or in the midst of the heroin epidemic of the 1980s and 1990s. Scientific and medical societies propose to make “a final effort of information and awareness” with opportunistic age screening of the population over 40 years old.
In practice, this means informing this population, when they come to their health center for other reasons, that it is advisable to take a blood test including the detection of hepatitis C. Always with informed consent. . At younger ages, specialists assure that the virus is practically eradicated.
I left the consultation crying; The doctor blamed me, he yelled at me, he said stupid things to me. He must have felt so bad that he followed me down the halls to apologize. I was completely unaware of the existence of the virus
Carmen Blas
— 69 years old, 23 years old with hepatitis C
These are very exceptional cases, warn all the professionals consulted. Carmen Blas is part of this target generation. She spent 23 years with hepatitis C: from diagnosis in 1993 until her treatment with Sovaldi in 2016, after a struggle by patients to have universal access to this innovative drug which cures 97% of patients. By then he was already suffering from cirrhosis of the liver.
When Blas’ infection was confirmed, the virus had recently been discovered. “I left the consultation crying; The doctor blamed me, he yelled at me, he said stupid things to me. He must have felt so bad that he followed me down the halls to apologize. “I had no idea the virus existed,” he said on the other end of the phone. He is 69 years old and “very eager to live.” She believes she contracted hepatitis during a procedure she underwent in 1992. Like Carmen, many patients accessed treatment late, when it was no longer possible to repair the fractures the virus had caused. in his body.
Some communities have screening
Now the problem is not access, but detection. Hepatitis C is transmitted through blood contact – like HIV for example – and does not cause symptoms, like “general liver diseases”. “The liver is a dangerous organ, hence the efforts to raise awareness among the population,” explains Marta Casado, president of FEAD and hepatologist at the Torrecárdenas University Hospital in Almería.
Screening has already been implemented in Galicia and Andalusia wants to launch it soon. “We think this is an important step for ultimate success,” defends Casado. Cantabria has had some problems: it started it in 2023 but interrupted it for allegedly violating patient autonomy by not being properly informed.
The Ministry of Health only plans to screen at-risk groups – such as injecting drug users, those who have sex at risk of bleeding, hemodialysis patients before 1975 – and is not currently considering implementing one. more general.
Next year, Gilead’s patent on antiviral drugs – one of the most expensive on the market – will expire. This means that the pharmaceutical company no longer has a monopoly.
The ministry’s argument is that everything detected today can be cured and that many doctors already offer their patients the hepatitis C test – it can be examined in the same way as HIV in a routine analysis. This debate comes at a key moment: next year, Gilead’s patent on antiviral drugs – one of the most expensive on the market – will expire. This means that the pharmaceutical company no longer has a monopoly.
“The journey of the last few decades has been fascinating. It was a liver disease that made patients very ill and now it can be cured, it is one of the greatest advances in medicine in the last ten years,” says the FEAD president. During this period, the number of liver transplants due to damage caused by the virus and the waiting list decreased by 50%, García-Samaniego adds. The last impulse remains, he says: “press the accelerator in active research”.
