Through the official letter n° 63, Department of Surveillance Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, the Ministry of Health answered to the letter sent by FOAESP, GIV and RNP+SP on November 23 and published here on November 29*.
On the Official Letter from November 30, the Ministry explains that the updated of the estimated data of hepatitis C in Brazil were conclude in partnership with Pan American Heath Organization (PAHO) and by the CDA (Center for Diseases Analysis), and, among the frameworked actions, it have been reassured the intention of treating every people carrying HCV in Brazil. Check the following document.
Circular letter nº 63-SEI/2017/COVIG/CGVP/DIAHV/SVS/MS
Brasília, November 30, 2017.
Addressed to the FOAESP, GIV and RNP+SP: Civil Society representatives
São Paulo, SP
Subject: Response to the FOAESP, GIV, and RNP+SP: Civil Society representatives.
1. The Ministry of Health in partnership with the PAHO/Washington and the CDA (Center for Diseases Analysis), took the initiative of updating, through developing a new Mathematical Model, the estimated epidemiological data on the epidemic of Hepatitis C in Brazil, aiming at improving care actions, prevention and treatment campaigns in our country. Part of that database have passed ahead preliminarily at the 11° Congress on HIV/AIDS and the 4° Congress on Viral Hepatitis. According to these results, it is estimated the prevalence of serum reagents (anti- HCV) in Brazil, is 0,7% approximately, which corresponds to approximately 1.032.000 HCV-seropositive individuals in Brazil. These individuals have been exposed to the virus but not necessarily have infected.
According to the surveillance data, it is estimated that 656.000 people are viremic and really in need of treatment. It is important to reinforce that it is estimated that the 0,7% prevalence refers to general population age 15 to 69, until 2016. The estimated surveillance data were elaborated on the basis of several Ministry of Health sectors database, publications and periodicals in the last five years, Anvisa’s blood donors database, conscript diagnosis studies, among others. For analysis, these data were compilated and validated with the collaboration of Brazilian researchers who make up the Technical Advisory Committee on Viral Hepatitis, technical staffs of the Ministry of Health from the PAHO and the CDA.
2. Based on the estimates above, it is observed the need of adding all efforts on identifying HCV-infected people, amplifying the distribution and undertaking HCV testing. Taking by consider that hepatitis C is a silent disease, it is crucial to vest in communications strategy, reinforcing the need of people age 40 or more to go after a healthcare service for advice as soon as possible.
3. Since 2011 the Ministry of Health purchased approximately 15 million HCV rapid tests. At the same time, the DIHV has prepared the Hepatitis C Elimination Plan, already adopted by the Tripartite Interagency Committee, which aimed to broad diagnosis, notification and treatment of hepatitis C. In order to meet demands the action developments are going to be articulated over the three Brazilian power instances, the Civil Society Organization, among other political actors.
4. Progressively the tratamentos are becoming more efficient and simplified, they are presenting less side effects day by day and the cure rate is increasing. The Ministry of Health is putting great effort on keeping tracking of technology innovations and, on December 4, 2017, announced to be registered two new drugs on the treatment of hepatitis C. Reinforcing through this action, its commitment on the treatment of every HCV infected person, promise made by the Ministry of Health, at the World Hepatitis Summit 2017, in São Paulo, Brazil. The access to treatment will happen independently on the fibrosis stage. It is worth to note that from 2015 until now, the Ministry of Health provided around 63.838 treatments with the new direct acting antiviral drugs.
5. Regarding to coinfected people, the Clinical and Therapeutic Guidelines for Hepatitis C and Coinfection, prioritized treatment for those people, independently of the liver fibrosis stage.
6. We are thankful for the collaboration and opportunity of discussion and we place ourselves at disposal for further clarification.
Adele Schwartz Benzaken
Headmistress of the Department of Surveillance Prevention and Control of STI, HIV/AIDS and Viral Hepatitis
(Document electronically signed)