British Viral Hepatitis Group
Introduction:
The BVHG aims to improve the management and study of patients with chronic viral liver disease. The group brings together UK hepatologists, gastroenterologists, infectious disease physicians, nurses and allied professionals as well as virologists, epidemiologists and scientists with an interest in viral diseases of the liver.
The work of the BVHG
The BVHG organises two one day meetings each year on varied topics related to viral hepatitis, as well as co-organising other sessions and meetings. These have proven to be very successful and well attended.
A Pharmacists sub-group is affiliated to the BVHG who are called the British Hepatology Pharmacy Group (BHPG).
The BVHG is also involved in reporting and representing to NICE and other organisations/government bodies on issues related to viral hepatitis, and has developed an advocacy role for clinicians and others interested in viral hepatitis care, treatment and study.
The BVHG is involved in liaising with the British Society of Gastroenterology Liver Section as well as the British HIV Association in areas of mutual interest. It played a pivotal role in the review of the best available evidence in the Management of Hepatitis C during a Consensus Conference in 2015.
It plans to develop more online educational content including setting up a Post-Conference Feedback Web Session.
The BVHG Committee
| BVHG Chair | Professor Patrick Kennedy, Barts and The London School of Medicine & Dentistry, QMUL |
| BVHG Secretary |
Dr Upkar Gill, Blizard Institute, Barts and The London School of Medicine & Dentistry, QMUL |
BVHG Committee Member Biographies
Professor Patrick Kennedy is a Consultant Hepatologist at Barts Health NHS Trust. His work in viral liver disease is known internationally and he is widely published in the field. He has produced novel work redefining disease phase in hepatitis B virus (HBV) and investigating the role of individualised treatment & management strategies for chronic hepatitis B (CHB) patients.
Professor Kennedy is the BVHG Chair and former lead for the British Association for the Study of the Liver (BASL) special interest group in HBV. He is a member of the WHO guideline development group and a member of the EASL clinical practice guideline committee for HBV. He previously served on the guideline committee for NICE and provides expert opinion for the United Kingdom Advisory Panel on blood-borne viruses. In addition, he is a key opinion leader in viral liver disease and a member of expert advisory panels for early drug development. In keeping with Professor Kennedy’s longstanding research interest and publication record in viral liver disease, he is the chief/principal investigator for a number of investigator-led and commercial phase 1, 2 and 3, clinical trials in HBV and hepatitis delta virus.
Dr Upkar Gill is a Senior Clinical Lecturer at QMUL and an Honorary Consultant Hepatologist. He undertook basic medical training at The University of Leeds, following which he started his career at Leeds Teaching Hospitals. He then moved to London to take up an ACF post, integrating his academic research interests with clinical training, which he completed in 2020. He has a strong background in hepatitis B immunology having trained in London and Singapore in world class labs during his doctoral and post-doctoral training funded by the Wellcome Trust and NIHR. He is currently funded by the Medical Research Foundation as a mid-career research fellow investigating defects of immune cells in chronic hepatitis B (CHB) infection and linking basic immunology with computational biology. He has published and contributed to several landmark papers (>60), highlighting key findings in HBV treatment and pathogenesis, and received high accolades including the Sir Francis Avery Jones Research medal and the Sheila Sherlock Award for research in the field.
BVHG Announcement on Access to Bulevirtide
Important developments for the treatment of Hepatitis Delta virus (HDV)
NHS England has confirmed that HEPCLUDEX ®▼ (bulevirtide) is now available via the Innovative Medicines Fund (IMF) until it is routinely commissioned through NHS England at NICE TAG + 90 days (5th September 2023).
Access to Bulevirtide will be restricted to those Trusts that are commissioned to provide a specialised hepatology service and will be available in line with the Technology Appraisal Guidance (TAG) TA896² for bulevirtide. This will need to be confirmed through completion of a Blueteq prior application form (patients will not need to be re-registered on Blueteq once bulevirtide moves into routine funding).
In the TAG, NICE recommends HEPCLUDEX (bulevirtide) for the treatment of chronic HDV infection, in adult patients who HDV-RNA positive in plasma (or serum) with compensated liver disease, if:
• There is evidence of significant fibrosis (METAVIR stage F2 or above or Ishak stage 3 or above), and
• They have not responded to peginterferon alfa-2a or they cannot have/are intolerant of interferon-based therapy.
For the full recommendation please refer to the NICE website.
Professor Patrick Kennedy on behalf of the BVHG
(04.08.2023)
Meetings - BVHG & HBV SIG Webinar Videos
BVHG and HBV SIG meeting on the 20th January 2023
Click to Download Programme - BVHG and HBV SIG meeting - 20th January 2023 V11.pdf
Please see below to view the presentations and recordiongs:
*Curing Hepatitis B and Delta – what are the different types of cure and why do we need them? - Dr Jane Abbott
Download 1 Curing Hep D and Delta_Jane Abbott.pdf
*Immunological approaches to achieving functional cure - Dr Upkar Gill
Download 3 Immunological approaches to achieving functional cure_ Upkar Gill.pdf
*The future of the functional cure programme – combinations, novel biomarkers and timelines - Professor Geoff Dusheiko
Download 4 The future of functional cure programmes_Geoff Dusheiko.pdf
*The lived experiences of people with hepatitis B infection - Chari Cohen from the Hepatitis B Foundation
Click > here to view the video
*Important considerations for patients taking part in clinical trials for hepatitis B functional cure - Dr Thomas Tu University of Sydney, Australia
Click > here to view the video
View the video of the webinar held on Friday 11th June 2021 here > https://youtu.be/eehZENKqRSg
Programme included:
Update on the HBV Survey - Dr Brian Thomson and Kate Jack
Ongoing and planned HBV quality of life studies - Dr Jane Abbott & Dr Eric Chan (Janssen)
HDV - Dr Ruth Simmons (PHE)
What lessons learnt from HCV elimination can be applied to the HBV functional cure programme - Dr Ahmed Elsharkawy
Watch the video of the webinar held on Friday 22nd January 2021 here > https://youtu.be/7AsYEknbYHg
Download BVHG HBV SIG Programme 22 Jan 2021.pdf
HCV Toolkit
Practical Toolkit for Building a Successful Partnership with High-Risk Hepatitis C Patients
Doctors and medical practitioners in Europe recognise the need for innovative strategies and practical tools that can help overcome formidable challenges in HCV testing and treatment, including when working with marginalised patient populations. Dr. Stephan Walcher, member of the Board of Directors for the European Opiate Addiction Treatment Association and Director of CONCEPT – Centre for Addiction Treatment, has pointed out that: “A lot of evidence has been compiled since the release of the first direct-acting antivirals, leading to adapted or newly issued guidelines. However, there has been a lack of simple, practical, and user-targeted handouts—something that both health care providers and patients can really work with”.
These practical tools have been vetted by renowned European HCV experts and are designed for use in primary care clinics, drug treatment centres, medically supervised injecting centres, street-based outreach programs, prisons, and criminal justice settings. The toolkits are available in English, French, German, Italian, and Spanish for both health care providers and patients. “Patient-centred communication is fundamental in eliminating hepatitis C, and I expect that these new tools will play an important role in engaging patients in effective conversations that foster strategic action toward HCV testing, treatment, adherence, and risk reduction.” —Prof. Jeffrey V Lazarus, PhD, MIH, MA, Faculty of Medicine, Barcelona Institute for Global Health (ISGlobal)
Download the free toolkits today:
Practical Toolkit for Building a Successful Partnership with High-Risk Hepatitis C Patients
1. Patient-Centred Communication is Key to Combating Hepatitis C
2. How to Talk to Your Patients About Hepatitis C
4. For Patients: How to Talk to Your Doctor or Nurse About Hepatitis C
Resources
National HCV pMDT ODN and an Observer Protocol
Download StakeholderCommunications update Sept 2021.pdf
Download Appendix1 Observer protocol National HCV pMDT ODN.pdf
For any BASL BVHG/HBV SIG member who wishes to join these meetings which provide an excellent opportunity to learn more about Treatments and management of children and young adults who are HCV +ve .
The antenatal guidelines for HBV have been updated this year and include additional surveillance for women at high risk of MTCT, with HBV DNA testing in the mother post-partum and HBsAg / HBV DNA testing at birth for the infant.
A link to the guidance is here: https://www.gov.uk/government/publications/hepatitis-b-antenatal-screening-and-selective-neonatal-immunisation-pathway/guidance-on-the-hepatitis-b-antenatal-screening-and-selective-neonatal-immunisation-pathway--2
Guideline for the Management of Hepatitis B in Pregnancy and the Exposed Infant: Download BVHG Perinatal HBV 3.3.21.pdf
PHE slide set: The hepatitis B antenatal screening and selective neonatal immunisation QI project:
Download PHE Hep B Quality improvement project Dec20.pdf
UK Position Statement on the use of Organs from Hepatitis C Viraemic Donors in Hepatitis C Negative Recipients:
Business Case Template - Hepatitis C Test & Treat Nurse-Led Community Based Service. Download the template below:
Download Business CaseTemplate ITTREAT v10. Final.docx
Acknowledgements
| This business case template is based on data from a pilot study undertaken in Brighton. Therefore acknowledgements to Dr Sumita Verma, Reader in Medicine Brighton and Sussex Medical School and Hon Consultant Hepatology, Brighton and Sussex University Hospital, Specialist Hepatitis Nurse Margaret O'Sullivan, Brighton and Sussex University Hospital and to all other staff at Brighton services (acute trust, substance misuse & public health) who have supported this important HCV development. Thank you to Alison McKinlay, Service Manager Brighton and Sussex University Hospital, for sharing the BSUH business case and local financial data. The template has been funded and commissioned by Gilead Sciences Ltd. Gilead had no editorial control over the document. |
Reports
Hepatitis C in England 2023 Report - updated 30th January 2024; a copy of the report can be found here: https://www.gov.uk/government/publications/hepatitis-c-in-the-uk
13th March 2024 - the data tables and slide set that accompany the Hepatitis C in England 2023 report have now been published at the above link.
The first BVHG and BASL Best Practice for ODN Stakeholders Meeting which was held on the 10–11 January 2018 in Manchester. The summary of the outputs from the meeting is provided in form of a meeting report; Download BVHG-BASL ODN meeting report Jan 2018.pdf
The report highlights the limitations of the current HCV treatment model, and provides suggestions on how it can be modified and improved. The report describes best practice examples for eliminating HCV for ODNs to take and adapt to work in their area. The intention is that this information will provide all ODNs with a framework to develop the 5-year plans needed to meet their CQUIN requirement, and importantly to also leave them well placed to deliver on the World Health Organisations goal of HCV elimination by 2030.
Supplementary BVHG and BASL Best Practice for ODN Stakeholders Meeting Information:
Download BVHG-BASL ODN stakeholders meeting presentation slides.pdf
Download BVHG-BASL ODN Meeting Best Practice Posters.pdf
Read the Hepatitis C Coalition Report on the Operational Delivery Networks – December 2017 > here.
Read the Hepatitis C Coalition Report - Signposting the way to elimination by 2025 - July 2018 > here Download Hepatitis C Coalition Signposting Elimination July 18.pdf.
