Hep C: more work to be done

liver with hepatitis virus render

Hepatitis C has declined by 60% among people who inject drugs since new cures for the disease were made available on the PBS, new data show

The report, released by the Kirby Institute at UNSW Sydney, was published in the leadup to World Hepatitis Day this Sunday.

It analysed data from people who inject drugs attending Australia’s Needle Syringe Programs (NSP).

Among this population, the proportion of people living with hepatitis C in 2018 was one in five, down from one in two in 2015 before the treatments were made available.

Researchers from the Kirby Institute say they believe that these reductions are due to high uptake of the new hepatitis C treatments and are an early indicator for reductions in transmission of hepatitis C Australia-wide.

“People who inject drugs are the major population at risk of hepatitis C in Australia, and thanks to forward-thinking and inclusive leadership from the Federal Government, people are able to access the cures at a low cost through the PBS,” said Dr Jenny Iversen, lead author of the report.

“Since these new treatments were added to the PBS, our report shows the number of people attending NSPs ever treated for hepatitis C has increased from 11% to 55%.”

As part of the report, researchers have also monitored the impact of the new treatments on prevalence of hepatitis C.

“Our results show that there are significantly less people living with hepatitis C, but also, that the risk of transmitting hepatitis C has more than halved since the introduction of the new treatments,” said Dr Iversen.

Australia was one of the first countries in the world to offer hepatitis C treatments at a low cost to all people living with the illness. Professor Greg Dore, head of the Kirby Institute’s Viral Hepatitis Clinical Research Program said that this approach could make Australia the first country in the world to eliminate hepatitis C.

“Many countries are looking to Australia as the ideal setting to achieve hepatitis C elimination,” he said.

“The focus on providing access to all, with more than 70,000 people now cured, together with specific initiatives for marginalised populations, means that people who inject drugs are equal recipients of these amazing advances.”

However, Hepatitis NSW warned this week, also ahead of the day of recognition on Sunday, that there is more work to be done.

It noted that while more than 22,000 people in NSW have started treatment for, and been cured of, hepatitis C since 2016, it is estimated that a further 58,000 across the state are yet to seek treatment and cure.

Meanwhile, the Society of Hospital Pharmacists of Australia welcomed media discussion of hepatitis C and the new medicines, with SHPA Chief Executive Kristin Michaels saying the recent history of promising new hepatitis medicines has been a “bright, albeit temporary” success story.

“As organisations mark Hepatitis Awareness Week, SHPA lends its voice to awareness-raising efforts to mitigate the health burden of untreated hepatitis C in the Australian community,” she said.

“The listing of hepatitis C medicines on the PBS in 2016 allowed some hospital pharmacy departments – with the capability to do so – to step up and proactively provided treatments to patients, as community treatment systems had not yet been established.”

Ms Michaels says with hepatitis C dispensing volumes from hospitals now a third of the early 2016 peak, the baton has passed from hospital pharmacy to primary care as the main setting for this important patient care.

“After an initial rush of prescriptions, SHPA supports sustained focus on ensuring many more Australians are able to access hepatitis C medicines, especially those from vulnerable populations.

“We are proud of our members who rose to the challenge over the last few years, cementing their role in reducing the burden of hepatitis C on the community; their commitment to evidence-based practice will ensure further engagement with government medicine priorities in the future.”

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