The State of São Paulo Forum on NGO/AIDS (FOAESP) urges through this memorandum the necessity of screening Hepatitis C among people living with HIV.

The current Hepatitis C treatment protocol looks at every HIV-positive individual, no matter what the liver fibrosis stage is. In the case of coinfection, Hepatitis C disease may advance faster among HIV-positive individuals, requiring extra care and attention in order to avoid potential complications or even death.

In the state of São Paulo, a place where more than half of the sick population is treated, the amount of coinfected individuals suffering from both diseases, such as Hepatitis C and HIV/AIDS (PVHA), is unknown.  Therefore it is crucial to obtain accurate database in order to treat the infected individuals and offer an increased quality of life. If successful, the above-mentioned information will allow the infected population opportunities to undergo specific treatments, suffer less, and may result in the possibility of enhanced treatment and ultimately a cure if available.

Based on the information above, we can conclude the urgency and need of HIV seropositive individuals’ Hepatitis C tests in addition to Hepatitis C test announcements at HIV health service locations.  This will allow our communities to detect the presence of the Hepatitis C virus among those individuals affected. The cost of the the test is not expensive and early desease detection will help affected populations have better life conditions, considering that the disease is more prevalent among those who are 40 years old or older.

As a reminder, a public consultation sponsored by the National Committee for Technology Incorporation at SUS – Brazilian public health service system (CONITEC) will take place until April 13th and will discuss Clinical Protocol and Therapeutic Guidelines for Hepatitis C and coinfections.

It is imperative that this topic be given the fullest extent of consideration and dissemination in order to raise treatment possibilities, mostly among fibrosis 2 stage people.

Rodrigo Pinheiro



Answer from the Ministry of Health

Office nº 511/2017/DDAHV/SVS/MS
Brasília, May 2nd 2017.

The Honorable Rodrigo Pinheiro, President of The State of São Paulo Forum on NGO/AIDS.
Subject: Surveying presence of Hepatitis C among HIV Seropositive Population

Dear Mr. Pinheiro,

1. The Ministry of Health, through the Secretariat of Health Surveillance and its Department of Surveillance, Control and Prevention of STI, AIDS and Viral Hepatitis (DIAHV), has, as its priorities, an unceasing screeing data base in order to identify how Viral Hepatitis infects HIV-positive population. As an action to obtain database and formulate better and more effective answers to coinfection cases, this Department has promoting several surveys and investigative actions, been some of them in database consolidation phase, getting evidences for this specific subject.

2. In 2016, The DIAHV concluded the database collect from three big surveys used to screen the HIV/AIDS, Syphilis and Viral Hapatitis, as well as habits, attitudes and associated practices with the risks of infection:
* Epidemiological Study about Syphilis, HIV, Hepatitis B and C prevalence and its behavioral factors associated to conscripts of the military, 8th edition; study developed from July to December, 2016, having DIAHV technical and scientific support and Dr. Rosa Dea Sperhacke from Universidade de Caxias do Sul/RS (Caxias do Sul/RS University) coordination.
* Two surveys about HIV, Syphilis and Hepatitis B and C prevalence among men who keep sexual relationship with men and sex worker women at the following Brazilian cities: Belém/PA, Belo Horizonte/MG, Brasília/DF, Campo Grande/MS, Curitiba/PR, Fortaleza/CE, Manaus/AM, Porto Alegre/RS, Recife/PE, Rio de Janeiro/RJ Salvador/BA e São Paulo/SP, with Ministry of Health financial and technical support and Dr. Ligia Regina Franco Sansigolo Kerr from Universidade Estadual do Ceará (UECE) and Dr. Célia Landman Szwarcwald from Fundação Oswaldo Cruz (FIOCRUZ), general coordination.

3. Within the PROADI-SUS the DIAHV supported the entitled projects Maintenance Support for STD, HIV/AIDS and Viral Hepatitis in the prioritarian assistance regions of the States of Santa Catarina and São Paulo, which aims to qualify all health service locations responsible for announcements, prevention and treatment of sexually transmitted infection, HIV, Viral Hepatitis B and C, in prioritarian assistance health regions in the States of Santa Catarina and São Paulo.

4. Technical Research Meetings:
* In 2016, a technical meeting was held involving the presence of the scientific community and civil society in order to discuss research priorities for the biennium 2017-2018, to promote fomentation to researches and technological development for STI, HIV and Viral Hepatitis.

5. The HIV, Syphilis and Hepatitis B and C among Transvestites and Transsexuals prevalence research, one coordinated by Dr. Francisco Inacio Pinkusfeld Monteiro Bastos e Dr. Monica Siqueira Malta, both from FIOCRUZ, will take place until the end of 2017.

6. Among surveillance and health care actions, this Department has made available an updated version of the Medicines- Treatment Form.
From now on, it is included on the 11th fill field, the option to inform possible coinfection with Hepatitis B, Hepatitis C and Tuberculosis.
The database collected by this field will allow a better and more complete clinical follow-up among HIV-postive population, besides contributing to support medicines purchase and surveillance actions.

7. Updated form access http://bit.ly2pdcWXb, page founded in SICLOM Gerencial:
The Testing Actions still been realised.