European HIV-Hepatitis Testing Week 2016: Test. Treat. Prevent.

Grupo de Ativistas em Tratamentos (GAT)/Clara Abdullah

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. Knowing your health status, however, is the prerequisite to accessing treatment. This is why WHO strongly supports European HIV-Hepatitis Testing Week, which aims to break the silence around 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 of their infection. Close to half of those who test positive are diagnosed at a late stage, delaying their access to treatment and increasing the chances 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 are also unaware of their infection, and are therefore at risk of developing cirrhosis or liver cancer. On average, fewer than 3% of patients with chronic hepatitis C receive treatment.

Momentum for Europe

This year’s Testing Week comes at a decisive time for the Region. At the 66th session of the WHO Regional Committee for Europe, the 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 HIV and viral hepatitis global strategies to the political, economic and epidemiological contexts of the Region. They reinforce the ambitious goals of ending the AIDS epidemic and eliminating viral hepatitis as a public health threat in the Region by 2030, and are aligned with Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages.

HIV testing

The Action plan for the health sector response to HIV in the WHO European Region outlines ambitious 90–90–90 targets, envisioning that by 2020:

  • 90% of people living with HIV know their HIV status;
  • 90% of people diagnosed with HIV receive antiretroviral therapy (ART); and
  • 90% of people receiving ART achieve viral load suppression.

Efforts to increase HIV testing will help the Region to achieve these 3 targets. To expand HIV testing, treatment and care, the 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 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 coinfections and comorbidities, particularly sexually transmitted infections, tuberculosis, hepatitis C and drug dependence; and
  • closely monitor ART success by implementing both regular testing of HIV viral load and strategies to minimize resistance to HIV drugs, and by using the data to inform national policies and guidelines on ART.

Hepatitis testing

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 people living with chronic hepatitis by 2020. To achieve this, the Action plan recommends that countries:

  • 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 behaviours;
  • 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 recently produced guidelines on HIV self-testing and partner notification services, which focus on how these additional approaches can be used to achieve the first of the 90–90–90 targets (to be launched on 1 December 2016). It also produced guidelines on hepatitis B and C testing, which recommend using different approaches for different populations and different testing strategies.

About European HIV-Hepatitis Testing Week

European HIV-Hepatitis Testing Week 2016 takes place on 18–25 November. When launched in 2013, the initiative aimed to help people become aware of their HIV status. In 2015, Testing Week expanded to include hepatitis. Hepatitis B and C infections are common among people at risk of or living with HIV, and the viruses can be transmitted in the same ways as HIV, namely through use of injected drugs and unsafe sex.

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. As a result, thousands of additional people are now aware of their HIV and hepatitis status. In 2016, nearly 500 organizations are expected to participate.