A SCOTTISH region is on track to eliminate a potentially lethal illness within four years in a world first.

As many as 50,000 Scots are thought to be infected with blood-borne hepatitis C (HCV), which can cause life-threatening liver damage if left untreated. The condition is most commonly caught through the sharing of needles in intravenous drug use. Now one health board is on track to wipe out the illness as a result of a pioneering prevention programme.

Professor John Dillon, consultant hepatologist at NHS Tayside, said: “The project is on course for Tayside to be the first region in the world to have eliminated HCV.”

The project targets injecting drug users in the Dundee area in a bid to prevent them passing the virus on to others. Standard treatment models for HCV focus on those who are no longer using drugs or are accessing help services in order to limit the damage done by the virus to their bodies, preventing it from leading to cirrhosis, liver failure or liver cancer.

While this has a benefit on individual cases, it may not have such a significant public health impact.

In contrast, the Dundee initiative, which is backed by the Scottish Government, seeks to end the spread of the condition by treating the people most likely to pass it on – those who are still using drugs More than 200 people have already been treated. Addressing Holyrood’s Health and Sport Committee yesterday, Dillon said: “In your career as an injecting drug user, perhaps you inject for several years before moving on to recovery. If you become infected with the virus during that time, you will potentially interact with six or seven other people who you will pass the virus on to.

“If you can offer treatment at a very early stage, while people who are infected are still actively injecting, when they have contact with other drug users and share equipment with other drug users, their chances of transmission disappear because they’re not infected any more. It’s the idea of treatment as prevention.”

Dillon said HCV prevalence among Dundee’s injecting drug users is expected to fall from 30 per cent to 10 per cent, with transmission reducing to below one per cent to trigger “the extinction of the virus” over just “two or three years”.

According to Dillon, in conjunction with medical help for former drug users with the condition, HCV as a whole can be “eliminated in Tayside potentially in four years’ time”.

On the limitations of traditional treatment models, Dillon “the bucket is constantly being refilled – new infections are constantly replacing the ones that you have treated”.

He added that the cost of maintaining existing care schemes would cost the health board £1.5-2 million a year, and that seeing 350-400 more patients would take this to around £2.1m.

Dr Emilia Crighton of NHS Greater Glasgow and Clyde said “probably all Scotland would want to use the model”. However, she cautioned it might not work for all patients, saying: “The addiction gets in the way of individuals engaging with the service and the treatment itself.”

Professor David Goldberg, of Health Protection Scotland, said as many as 5000 people in Scotland have chronic HCV symptoms, with up to 99 per cent of transmissions related to injecting drug use.

He added: “The concept of treatment to prevent onward transmission is a really good one. I have absolutely no doubt it will help. The big question is to what extent and for how long. That is why we are doing this research. We don’t have all the answers here. It’s possible the outcome will be different to what we thought.”

Dillon said he could now make the argument to the finance director: “Give me this money for three years and I’ll hand back my drug budget and will not ask you for any more. There is no other clinician that can go to a finance director other than those who are treating hepatitis C and be able to say that.”