§ Miss Melanie JohnsonTo ask the Secretary of State for Health what is his Department's policy in respect of screening for, and treatment of, hepatitis C. [12300]
§ Ms JowellBlood donations have been screened for antibodies to hepatitis C virus since September 1991 when reliable tests first became available. Recipients of blood or blood components donated before that date from donors since found to be carriers of hepatitis C virus are being traced in order to provide counselling, testing and 827W specialist referral as appropriate. Organs and tissue, resulting from either live or cadaveric donations, are also screened for hepatitis C.
Injecting drug misusers who share contaminated equipment are at increased risk of acquiring hepatitis C infection. The guidance to purchasers of drug treatment and care services, which the Department issued in March 1997, included advice for purchasers on dealing with those who seek testing for hepatitis C. The "Guidelines for Doctors on the Clinical Management of Drug Misusers" last issued in 1991 are currently being revised and will be published next year. They will include updated advice on the management of hepatitis C in drug misusers.
There is a need to increase knowledge about the natural history, prevalence, transmission and treatment of hepatitis C so that the National Health Service is equipped to deliver services based on the best scientific advice available about the disease. In 1996, the Department made £1 million available for research in these areas. The results of the research commissioned so far will become available over the next three years. A further £500,000 will be allocated this year to expand the research programme.
In addition, the NHS Health Technology Assessment is considering research proposals to establish the effectiveness of the early treatment of chronic hepatitis C with alpha interferon. The NHS Executive is funding the Royal College of Physicians to facilitate the development of clinical guidelines on the appropriate use of alpha interferon in patients with hepatitis C.
§ Miss Melanie JohnsonTo ask the Secretary of State for Health what assessment his Department has made as to the economic and social consequences to individuals and to the Exchequer of not treating hepatitis C. [12301]
§ Ms JowellAttempts to estimate the long term consequences of hepatitis C to the individual and the Exchequer are confounded by the unpredictability of the progression of the disease. Some individuals will clear the virus naturally, developing no long term symptoms, and others will go on to develop liver disease but often not for 20 to 30 years after initial infection with the virus. A proportion of those with liver disease will go on to develop liver failure or liver cancer.
Current knowledge about the natural history is insufficient to make firm estimates of the type requested. There is a comprehensive programme of research in place examining the natural history, transmission and prevalence of hepatitis C. Consideration is also being given through the Health Technology Assessment Programme to funding a clinical trail to examine the clinical and the cost effectiveness of treating hepatitis C with drug therapy at an earlier stage than is current clinical practice. These studies should enable some comparison to be made about the relative clinical effectiveness of treatment at different stages of the disease and will facilitate the evaluation of the economic and social costs of hepatitis C.