Tag: hepatitis C

Categories : Gender Substance UseTags : Leave a comment

Care for Women and Harm Reduction Services Under the Spotlight

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Facing off a dual burden of high disease risk and low service access

Photo by Sydney Sims on Unsplash

CAPE TOWN, 08 OCTOBER 2025: South African and international leaders in public health will gather on Friday, 10 October 2025 at the University of Cape Town to convene an in-person scientific seminar: Agents of change and women who use drugs. Women who use drugs (WWUD) in South Africa face compounded health and social vulnerabilities that leave them disproportionately excluded from essential health services. Compared to men, women experience heightened stigma, intimate partner violence, reproductive health challenges, and structural barriers such as childcare responsibilities and lack of women-centred care.1,2 Scientific discussions among academics will focus on how women can be supported through access to harm reduction programming and drug policy reform.  

 Seminar: Agents of change and women who use drugs

·        Date    : 10 October 2025

·        Time    : 13:30 – 15:30 (SAST)

·        Venue  : Neurosciences Institute Auditorium, UCT/Groote Schuur Hospital, Cape Town

·        Registration

Recent evidence highlights both the scale of drug use and the urgent need for tailored harm reduction. National estimates suggest there are approximately 82 500 people who inject drugs (PWID) in South Africa, with women comprising between 16% and 27% of this population.3 Led by TB HIV Care, a 2023 bio-behavioural survey across four South African sites documented extremely high HIV prevalence among PWID: 72.1% in Tshwane, 49.3% in eThekwini, 45.4% in Mashishing, and 30.3% in Mbombela. Hepatitis C (HCV) prevalence was similarly alarming, reaching 89% in Tshwane and over 75% in multiple sites.3

“The evidence consistently shows that harm reduction works,” says Dr Andrew Scheibe, medical doctor and technical advisor with TB HIV Care in Cape Town, INHSU board member, and fellow co-convener of the upcoming INHSU 2025 conference. “Harm reduction reduces infections, prevents overdose, and connects people to healthcare, yet access across Africa remains the exception rather than the rule.”

Sex-based disparities are stark. While HIV prevalence among PWID overall has ranged from 14% to over 70%, women consistently show higher prevalence rates than men. One multi-city study found 18% HIV prevalence among female PWID, compared to 13% among males.4 More recent research in Durban confirmed that women face greater barriers to accessing sexual and reproductive health, harm reduction, and HIV services, often due to fear of arrest, intimate partner control, and lack of programming designed for women.5

“Everyone in our communities deserve health, dignity, and care,” says Mfezi Mcingana, Programme Director: Key Populations at TB HIV Care. “People who use drugs are part of our communities and supporting their access to healthcare, not punishment, builds a safer, healthier society for all”, Mcingana concludes.

Despite the magnitude of risk, women remain underrepresented in harm reduction programmes. In opioid agonist therapy (OAT), fewer than 10% of participants are women.6 Needle and syringe programmes (NSPs) and OAT are limited in coverage, mostly urban-based, and not designed with women’s needs in mind. The absence of services aimed at women perpetuates cycles of preventable morbidity, mortality, and infectious disease transmission.

“While the scale of the challenge is undeniable, pioneering efforts by a few African governments show what harm reduction leadership can look like,” says Angela McBride, Executive Director of the South African Network of People Who Use Drugs (SANPUD), INHSU board member, and co-convener of INHSU 2025. “Harm reduction means putting health and human rights before punishment, shifting away from criminalisation and towards evidence-based, rights-affirming policies.”

To address this gap, investment in women-centred harm reduction is essential. Priorities include scaling up OAT and NSPs with women-specific entry points, integrating sexual and reproductive health services into harm reduction sites, providing childcare support, and ensuring protection from intimate partner violence. Without these interventions, WWUD in South Africa will continue to be excluded from public health progress and national HIV/HCV response goals.

References:

  1. Shirley-Beavan, S., Roig, A., Burke-Shyne, N., Daniels, C. and Csak, R. (2020). Women and barriers to harm reduction services: a literature review. Harm Reduction Journal, 17(74). Available here.
  2. Harm Reduction International & South African Network of People Who Use Drugs (SANPUD) (2020). Barriers to harm reduction for women who use drugs in South Africa. London: Harm Reduction International. Available here.
  3. SANPUD (2023). South African bio-behavioural survey and population size estimation among people who inject drugs. Johannesburg: South African Network of People Who Use Drugs. Available here.
  4. Scheibe, A., Young, K., Moses, L., Basson, R., Versfeld, A., Spearman, C.W. and Sonderup, M.W. (2016). HIV prevalence and risk among people who inject drugs in South Africa. International Journal of Drug Policy, 30, pp.107–113. Available here.
  5. Milford, C., Cavanagh, T., Bosman, S., Chetty, T. and Rambally, G. (2024). Access to and acceptability of sexual and reproductive health, harm reduction and other essential health services among people who inject drugs in Durban, South Africa. Harm Reduction Journal, 21(123). Available here.
  6. INHSU (2021). Gender and opioid substitution therapy access in Tshwane, South Africa. International Network on Health and Hepatitis in Substance Users. Available here.
Categories : Diseases, Syndromes and ConditionsTags :

South Africa Marked World Hepatitis Day with a Call to Eliminate Viral Hepatitis by 2030

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Hepatitis C virus. Credit: Scientific Animations CC4.0

On the 28th of July, South Africa joined the global community in marking World Hepatitis Day 2025, which is observed annually to raise awareness of viral hepatitis and to call for urgent action to eliminate it as a public health threat.

Under the theme “Let’s Break It Down,” this year’s campaign urged governments, healthcare systems, and communities to dismantle the financial, social, and systemic barriers that hinder progress—particularly stigma, underdiagnosis, and lack of access to testing and treatment.1

More than 304 million people globally are living with chronic hepatitis B or C, yet the majority remain undiagnosed until it is too late. In South Africa alone, over one million new cases are reported each year—despite the fact that hepatitis B is vaccine-preventable and hepatitis C is curable with available therapies. 1,2

Dr Neliswa Gogela, hepatologist, commented: “Hepatitis B and C are silent killers. People often do not know they’re infected until severe liver damage or cancer develops. But this is a crisis we can stop. We have vaccines, we have treatment, and we have the tools – we simply need to scale up access, embed hepatitis care into our health system, and break the stigma so people are not afraid to get tested or treated.”

Although hepatitis is preventable, treatable, and often curable, only 45% of babies globally received the hepatitis B birth dose vaccine within 24 hours of birth in 2022—a critical early intervention. South Africa has made notable strides, yet challenges remain in ensuring equitable access, particularly in rural and underserved areas. 1,2

Understanding the Disease

Hepatitis refers to inflammation of the liver, most often caused by a viral infection. The most common types, hepatitis B (HBV) and hepatitis C (HCV), are both blood-borne and can lead to chronic liver disease, liver failure, and liver cancer.

  • Hepatitis B is spread through contact with infected blood or bodily fluids, unprotected sex, and from mother to child at birth. It is preventable through vaccination, which has been available for over four decades.1
  • Hepatitis C is commonly spread through unsafe medical practices, contaminated injections, or sharing needles. While there is no vaccine, hepatitis C is curable in most cases with a class of medicines known as direct-acting antiviral medications.1

Because symptoms often only appear in advanced stages, early testing and diagnosis are vital to preventing life-threatening complications.

Time to Act – Before It’s Too Late. Speak to your healthcare practitioner for more information.

Viral hepatitis causes an estimated 1.3 million deaths each year—a figure comparable to that of HIV/AIDS. Yet countries such as Egypt have proven that elimination is achievable through aggressive, integrated screening and vaccination efforts.2

South Africa has the science, tools, and expertise to respond effectively. What is now needed is national commitment, adequate investment, and a public health approach that embeds hepatitis services into primary care.

World Hepatitis Day 2025 served as a timely reminder: the elimination of viral hepatitis is within reach—but only if we act now.

Source – accessed 24 July 2025:

  1. World Health Organization.  World Hepatis Day 2025.  Hepatitis Lets Break it down.  Available from: World Hepatitis Day 2025. Fact sheets
  2. World Hepatitis Alliance.  What is Viral Hepatitis.  Available from: Home – World Hepatitis Alliance. What is Viral Hepatitis – World Hepatitis Alliance
Categories : Diseases, Syndromes and Conditions VaccinesTags :

Research on the Hepatitis C Virus Reveals its Mysteries

On By ModernMedia
Hepatitis C virus. Credit: Scientific Animations CC4.0

Around 58 million people suffer from chronic inflammation caused by the hepatitis C virus, and 300 000 people die from the disease every year. So far, no treatment has successfully managed to reduce the global prevalence of hepatitis C, prompting scientists to start looking for a vaccine. But limited knowledge of the protein complex that enables the virus to infect the cells has made this difficult.

A new study by a cross-disciplinary research team at the University of Copenhagen is about to change that. It is out now in the journal Nature.

“We are the first ever to identify the protein complex at the surface of the hepatitis C virus that enables it to bind to our cells,” says Associate Professor Jannick Prentø.

“This knowledge of the structure of the protein complex will enable us to design vaccine candidates that can prevent the virus from infecting the cells,” says Postdoc Elias Augestad.

The protein complex helps the virus bind to the cells. In the corona virus, it is a so-called spike protein with the well-known spikes. In the hepatitis C virus, the structure is different, but the function of the protein complex is the same.

Paves the way for vaccine development

The study can be considered a blueprint for HCV vaccine development. Scientists hope to be able to use the new knowledge to develop a vaccine which will make the immune system produce antibodies that bind effectively to the surface of the hepatitis C virus and thus render it harmless.

“Expressing and cleaning up the protein complex is extremely difficult, which is why it has not been done before. The structure of these proteins on the surface of the hepatitis C virus makes them extremely vulnerable. Researchers did not know what they were dealing with, and therefore, whenever someone tried to reproduce these protein structures in the lab they would fall apart before they could get a chance to study them,” says Associate Professor Jannick Prentø.

“But we managed to describe their structure, and this has enabled us to reproduce these protein complexes outside the cell and study them closely,” says Associate Professor Pontus Gourdon.

Source: University of Copenhagen

Categories : Immune SystemTags :

Hepatitis C Leaves “Scars” in Immune Cells Even After Successful Treatment

On By ModernMedia

Study reveals epigenetic changes in regulatory T cells of hepatitis C patients post-treatment

A new study published in the Journal of Hepatology has revealed the lasting effects of chronic Hepatitis C virus (HCV) infection on the immune system, even after the disease has been successfully treated. The researchers discovered that traces of “epigenetic scars” remain in regulatory T cells and exhibit sustained inflammatory properties long after the virus is cleared from the body.

Chronic hepatitis C, can lead to severe complications such as liver cirrhosis and liver cancer. The advent of highly effective direct-acting antivirals (DAAs) has resulted in high cure rates for this chronic viral infection. However, it has been reported that the immune system of patients does not fully recover even after being cured.

The study examined patients with chronic HCV infection who achieved sustained virologic response (SVR) after DAA treatment. SVR means that the HCV virus is not detected in blood for 12 weeks after treatment, which is a strong indicator that the virus has been eradicated from the body. The researchers found that the frequency of activated TREG cells remained elevated during treatment and continued to be high even after the virus was eliminated.

The researchers then performed comprehensive analyses, including RNA sequencing and ATAC-seq, which revealed that the transcriptomic and epigenetic landscapes of TREG cells from HCV patients remained altered even after eradication of the virus. Inflammatory features, such as increased TNF signaling, were sustained in TREG cells, indicating long-term immune system changes induced by the chronic infection. These activated TREG cells from HCV patients continued to produce inflammatory cytokines like TNF, IFN-γ, and IL-17A even after clearance of the virus. The researchers followed the patients for up to six years after achieving SVR and found that inflammatory features still persisted.

The study’s results have significant implications for the long-term management of patients who have been treated for chronic HCV infection. Despite successful viral clearance, the persistence of inflammatory features in TREG cells suggests that these patients may be at risk for ongoing immune system dysregulation. This could potentially lead to chronic inflammation and related health issues.

Director Shin Eui Cheol, leader of the study, explained: “Our findings highlight the need for ongoing monitoring even after HCV has been cleared. By understanding the underlying mechanisms of these persistent immune changes, we can develop more effective strategies to ensure complete recovery and improve the quality of life for HCV patients.”

The research team is now focusing on further investigating the mechanisms behind the sustained inflammatory state of TREG cells. They aim to explore potential therapeutic interventions that could reverse these epigenetic and transcriptomic changes.

“We are now interested in seeing whether other chronic viral infections also cause long-lasting epigenetic changes in our immune systems,” said Director Shin. “One of our goals is to identify clinical implications of these persistent immune alterations.”

Source: Institute for Basic Science