Schatz Eberhard, Schiffer Katrin, Maher Mags, Harris Magdalena, Roca Xavier Major, Maticic Mojca, Leicht Astrid
Correlation Network, Amsterdam, The Netherlands.
European Network of People Who Use Drugs, London, UK.
Hepatol Med Policy. 2016 Oct 18;1:14. doi: 10.1186/s41124-016-0021-9. eCollection 2016.
The treatment of hepatitis C has entered a new era since the advent of curative pharmaceuticals. As policy, government and civil society assemble in response, there are still gaps to be addressed. The Manifesto on Hepatitis C and Drug Use, launched in Berlin during the Correlation Hepatitis C Initiative conference in October 2014, was formulated and endorsed by many key organizations in the hepatitis field. The Manifesto takes strides to pinpoint shortcomings in hepatitis action oriented towards the population most affected by the hepatitis C virus (HCV): active drug users. Despite a considerable amount of evidence that active drug users are disproportionately affected by HCV, barriers to care remain. Engagement with representatives of communities of people who inject drugs (PWID) is imperative in order to effectively create guidelines which reflect reality. Unfortunately, widespread systemic stigmatization and lack of trust between affected communities, decision-makers and healthcare professionals have reproduced this divide. The Berlin Manifesto has identified a disconnect between evidence and action which must be answered. In this roundtable discussion, experts from diverse parts of the hepatitis community have contributed their perspectives and experience on access to prevention, testing, and treatment for HCV in PWID. The authors discuss relevant topics such as realities of access to HCV treatment in the United Kingdom, interventions of a regional network of active drug users in Europe and lack of PWID involvement in government policy in Catalonia. Collectively they challenge the neglect of HCV in PWID by many decision-makers and health care professionals and promote a scale-up of integrated prevention and treatment strategies focusing on this population. The authors' conclusions aim to clarify the discourse on hepatitis in order to prevent disease, save lives and work towards eventual hepatitis elimination.
自治愈性药物问世以来，丙型肝炎的治疗进入了一个新时代。随着政策制定者、政府和民间社会齐聚一堂做出回应，仍有一些差距有待解决。2014年10月在丙型肝炎关联倡议会议期间于柏林发布的《丙型肝炎与药物使用宣言》，是由肝炎领域的许多关键组织制定并认可的。该宣言努力指出针对受丙型肝炎病毒（HCV）影响最严重人群——活跃吸毒者的肝炎防治行动中的不足之处。尽管有大量证据表明活跃吸毒者受HCV影响的比例过高，但获得治疗的障碍依然存在。为了有效制定反映现实情况的指南，与注射吸毒者群体的代表进行接触至关重要。不幸的是，普遍存在的系统性污名化以及受影响社区、决策者和医疗保健专业人员之间缺乏信任，使得这种分歧一直存在。《柏林宣言》指出了证据与行动之间的脱节，这一问题必须得到解决。在本次圆桌讨论中，来自肝炎领域不同方面的专家分享了他们对于注射吸毒者获得丙型肝炎预防、检测和治疗的看法及经验。作者们讨论了相关话题，如英国丙型肝炎治疗可及性的实际情况、欧洲一个活跃吸毒者区域网络的干预措施以及加泰罗尼亚注射吸毒者未参与政府政策制定等问题。他们共同挑战了许多决策者和医疗保健专业人员对注射吸毒者丙型肝炎问题的忽视，并推动扩大针对这一人群的综合预防和治疗策略。作者们的结论旨在澄清关于肝炎的讨论，以预防疾病、拯救生命并努力最终消除肝炎。
