The Berlin Hepatitis C Manifesto: access to prevention, testing, treatment and care for people who use drugs.

The treatment of hepatitis C has entered a new era since the advent of curative pharmaceuticals. As policy, government and civil society assemble in response, there are still gaps to be addressed. The Manifesto on Hepatitis C and Drug Use, launched in Berlin during the Correlation Hepatitis C Initiative conference in October 2014, was formulated and endorsed by many key organizations in the hepatitis field. The Manifesto takes strides to pinpoint shortcomings in hepatitis action oriented towards the population most affected by the hepatitis C virus (HCV): active drug users. Despite a considerable amount of evidence that active drug users are disproportionately affected by HCV, barriers to care remain. Engagement with representatives of communities of people who inject drugs (PWID) is imperative in order to effectively create guidelines which reflect reality. Unfortunately, widespread systemic stigmatization and lack of trust between affected communities, decision-makers and healthcare professionals have reproduced this divide. The Berlin Manifesto has identified a disconnect between evidence and action which must be answered. In this roundtable discussion, experts from diverse parts of the hepatitis community have contributed their perspectives and experience on access to prevention, testing, and treatment for HCV in PWID. The authors discuss relevant topics such as realities of access to HCV treatment in the United Kingdom, interventions of a regional network of active drug users in Europe and lack of PWID involvement in government policy in Catalonia. Collectively they challenge the neglect of HCV in PWID by many decision-makers and health care professionals and promote a scale-up of integrated prevention and treatment strategies focusing on this population. The authors' conclusions aim to clarify the discourse on hepatitis in order to prevent disease, save lives and work towards eventual hepatitis elimination

Prävalenz von sexuell und durch Blut übertragenen Infektionen und Tuberkulose bei Menschen in Wohnungs­losigkeit in Berlin – Erste Ergebnisse der Pilotstudie POINT

Das RKI hat in Kooperation mit Fixpunkt e. V. und BeSog Berliner Sozialprojekte gGmbH die Querschnittsstudie POINT initiiert, um valide Aussagen zur Prävalenz von sexuell und durch Blut übertragbaren Infektionen und Tuberkulose bei wohnungslosen Personen treffen zu können. Mit den gewonnenen Daten sollen Präventions- und Versorgungsangebote ausgestaltet sowie internationale Strategien zur Eliminierung der untersuchten Infektionen unterstützt werdenPeer Reviewe

Prävalenz von sexuell und durch Blut übertragenen Infektionen und Tuberkulose bei Menschen in Wohnungs­losigkeit in Berlin – Erste Ergebnisse der Pilotstudie POINT

Das RKI hat in Kooperation mit Fixpunkt e. V. und BeSog Berliner Sozialprojekte gGmbH die Querschnittsstudie POINT initiiert, um valide Aussagen zur Prävalenz von sexuell und durch Blut übertragbaren Infektionen und Tuberkulose bei wohnungslosen Personen treffen zu können. Mit den gewonnenen Daten sollen Präventions- und Versorgungsangebote ausgestaltet sowie internationale Strategien zur Eliminierung der untersuchten Infektionen unterstützt werdenPeer Reviewe

A multicentre sero-behavioural survey for hepatitis B and C, HIV and HTLV among people who inject drugs in Germany using respondent driven sampling

Background: People who inject drugs are at high risk for hepatitis B, hepatitis C and HIV. HTLV was reported by neighboring countries to be prevalent in this population, but the situation for Germany is unclear. To generate seroprevalence and related behavioural data and to enhance prevention efforts against these infections for drug users in Germany, a multicentre sero- and behavioural survey was initiated. People who inject drugs are not well reached by services for testing and counselling for blood-borne infections in Germany. An interventional part of the study is intended to prove feasibility and acceptance of testing and counselling in low-threshold drop-in settings. Methods/Design: Between May 2011 and March 2015, eligible participants (persons having injected drugs within the last 12 months, aged 16 years+, and living in the study city) are recruited by respondent driven sampling, using low-threshold drop-in facilities as study-sites in eight German cities with large drug scenes. Calculated sample size is 2,033 participants. Capillary blood samples collected as dried blood spots are anonymously tested for serological and molecular markers of hepatitis B and C, HIV, and HTLV I and II. A detailed face-to-face-interview about hepatitis- and HIV-related knowledge, former testing, imprisonment, sexual and injecting risk behaviour is conducted with participants. Staff is trained to offer pre- and post-test-counselling of blood-borne infections and HIV rapid testing to participants. Discussion: We chose respondent driven sampling for recruitment of participants to improve representativeness of results. Persons, who are not reached by the facility where the study is conducted, are aimed to be included by recruitment through their personal social network of injecting drug users. To reduce differential biases in the questions on knowledge of transmission and prevention of infections, we present true statements on hepatitis B, C and HIV, their possible routes of transmission and measures of prevention to participants. Participants are told that the statements are true and are asked to answer if they knew this fact already or if it is new to them. In case of knowledge gaps they are offered free targeted counselling as well as free HIV rapid testing and post-test counselling of HIV and hepatitis test results