Peer support for people living with hepatitis B virus—A foundation for treatment expansion

Author:

Downs Louise O.123ORCID,Kabagambe Kenneth4ORCID,Williams Sarah5,Waddilove Elizabeth6ORCID,Delphin Marion6ORCID,Lumley Sheila F.23ORCID,Ndungutse Richard7,Kimono Beatrice7,Newton Robert78ORCID,Ko Joy9,Martyn Emily1011ORCID,Carter Jessica12,Kemper Agnieszka9,Monteiro Fernando9,O'Regan Sive13,Surey Julian1314ORCID,Sultan Binta1114ORCID,Story Alistair13,MacDonald Douglas15,Tu Thomas16171819,Seeley Janet1020,Dusheiko Geoffrey21ORCID,Maponga Tongai22ORCID,Andersson Monique I.323ORCID,Spearman C. Wendy24ORCID,Tucker Joseph D.10,Cohen Chari25ORCID,Wang Su2526ORCID,Adda Danjuma2728,Freeland Catherine25ORCID,Halford Rachel2729ORCID,Jack Kathryn30ORCID,Ghosh Indrajit913,Elsharkawy Ahmed M.31ORCID,Matthews Philippa C.6911ORCID,Flanagan Stuart911

Affiliation:

1. KEMRI Wellcome Trust Research Programme Kilifi Kenya

2. Nuffield Department of Medicine University of Oxford Oxford UK

3. Department of Infectious Diseases and Microbiology Oxford University Hospitals NHS Foundation Trust Oxford UK

4. The National Organization for People Living with Hepatitis B (NOPLHB) Kampala Uganda

5. British Liver Trust Winchester UK

6. The Francis Crick Institute London UK

7. Uganda Virus Research Institute Entebbe Uganda

8. Department of Health Sciences University of York York UK

9. Mortimer Market Centre, Central North West London NHS Foundation Trust London UK

10. London School of Hygiene and Tropical Medicine London UK

11. Department of Infectious Diseases University College London Hospitals London UK

12. The Institute for Infection and Immunity St George's University of London London UK

13. Find and Treat, University College London Hospitals London UK

14. Institute for Global Health, University College London London UK

15. Department of Hepatology Royal Free Hospital NHS Foundation Trust London UK

16. Storr Liver Centre The Westmead Institute for Medical Research, The University of Sydney at Westmead Hospital Westmead New South Wales Australia

17. Centre for Infectious Diseases and Microbiology Sydney Infectious Diseases Institute, The University of Sydney at Westmead Hospital Westmead New South Wales Australia

18. HepBCommunity.org Sydney New South Wales Australia

19. Hepatitis B Voices Australia Melbourne Victoria Australia

20. Africa Health Research Institute KwaZulu‐Natal South Africa

21. Department of Hepatology King's College Hospital NHS Foundation Trust London UK

22. Division of Medical Virology, Faculty of Medicine and Health Sciences Stellenbosch University and National Health Laboratory Service Cape Town South Africa

23. Radcliffe Department of Medicine University of Oxford Oxford UK

24. Division of Hepatology, Department of Medicine, Faculty of Health Sciences University of Cape Town Cape Town South Africa

25. Hepatitis B Foundation Doylestown Pennsylvania USA

26. Cooperman Barnabas Medical Center Florham Park New Jersey USA

27. World Hepatitis Alliance London UK

28. CFID/CCT Taraba Tarabba Nigeria

29. The Hepatitis C Trust London UK

30. Hepatology Department Nottingham University Hospitals NHS Trust Nottingham UK

31. Liver Unit and National Institute for Health Research Biomedical Research Centre at the University Hospitals Birmingham University of Birmingham Birmingham UK

Abstract

AbstractChronic hepatitis B infection (CHB) affects 300 million people worldwide and is being targeted by the United Nations 2030 Sustainable Development Goals (SDGs) and the World Health Organisation (WHO), working towards elimination of hepatitis B virus (HBV) as a public health threat. In this piece, we explore the evidence and potential impact of peer support to enhance and promote interventions for people living with CHB. Peer support workers (PSWs) are those with lived experience of an infection, condition or situation who work to provide support for others, aiming to improve education, prevention, treatment and other clinical interventions and to reduce the physical, psychological and social impacts of disease. Peer support has been shown to be a valuable tool for improving health outcomes for people living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), but to date has not been widely available for communities affected by HBV. HBV disproportionately affects vulnerable and marginalised populations, who could benefit from PSWs to help them navigate complicated systems and provide advocacy, tackle stigma, improve education and representation, and optimise access to treatment and continuity of care. The scale up of peer support must provide structured and supportive career pathways for PSWs, account for social and cultural needs of different communities, adapt to differing healthcare systems and provide flexibility in approaches to care. Investment in peer support for people living with CHB could increase diagnosis, improve retention in care, and support design and roll out of interventions that can contribute to global elimination goals.

Funder

UCLH Biomedical Research Centre

National Institute for Health and Care Research

National Health and Medical Research Council

Wellcome Trust

University of Oxford

Francis Crick Institute

Publisher

Wiley

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