Hepatitis C eradication possible: expert

The new antivirals mean Australia is on track to eradicate hepatitis C, says one expert

Associate Professor Simone Strasser, gastroenterologist at Royal Prince Alfred Hospital in Sydney, says the country could eradicate hepatitis C in the next 10–15 years.

When the PBS listing of these drugs was announced by then Health Minister Sussan Ley, she said this was her objective.

“Australia is one of the first countries in the world to publicly subsidise these cures for every one of our quarter-of-a-million Hep C suffers, no matter what their condition or how they contracted it,” Ms Ley said at the time.

“This is a watershed moment in Australian history and we are hoping to eliminate one the great disease challenges facing Australia in the 21st century.”

Now, writing in the latest edition of Australian Prescriber, Professor Strasser says that the new oral antiviral treatments for hepatitis C are so effective and well tolerated that 95% of patients will be cured with a short course of treatment.

The PBS listing and wide prescriber base of these antivirals mean new cases of hepatitis will become rare. Consequently liver disease, liver failure, liver cancer and liver transplantation will decrease.

However this outcome can only be achieved if all people with chronic hepatitis C are diagnosed, assessed, treated and followed up appropriately, says Professor Strasser. Strict regime adherence is vital in order to effect a cure, he says.

“It is essential that all medical practitioners, particularly GPs, have the skills to diagnose patients with hepatitis C and either manage them with specialist support if needed, or refer them for specialist care.”

It is estimated that 82% of the 227,000 people living with hepatitis C in Australia have been diagnosed. However, many of them have either not been informed of their diagnosis or are not aware of the implications of chronic viral hepatitis.

Before 2016, less than one in four Australians with chronic hepatitis C had been treated and approximately one in five was undiagnosed. Because hepatitis C is a major cause of chronic liver disease, cirrhosis and liver cancer, it is essential that all people with chronic infection are identified so that treatment can be provided, he says.

“Anyone at risk of contracting a blood-borne infection should be tested for hepatitis C, as should anyone with evidence of chronic liver disease or abnormal liver enzymes,” says Professor Strasser.

“Approximately 80% of those infected are injecting drug users, and so should be a major focus for testing. Other important groups include migrants from high-prevalence countries or regions such as Egypt, Pakistan, Mediterranean and eastern European countries, Africa and Asia.”

Financial concerns for pharmacies supplying the expensive new-generation antivirals are ongoing.

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  1. pagophilus

    Not unless you address behaviour as well. Unless you treat everyone simultaneously. As long as there is a reservoir of Hepatitis C in the community, and as long as people practice high risk behaviour you will never eliminate hepatitis C. But nobody wants to address behaviour today for fear of offending the snowflake generation.

  2. Drugby

    It is correct that successful treatment and eradication of hep C does not protect a person from reinfection. However many Australians with hep C contracted the virus 20-30 years ago and are not using illicit drugs now, so the likelihood of reinfection is minimal. In addition, the awareness and availability of syringes, injecting drug rooms as well as the pharmacy harm minimisation program has made a significant impact on the spreading of blood-born viruses like hep C. The newer pangenotypic drugs are likely to be even shorter treatment duration (8 weeks) plus the costs are coming down.

  3. Obsessive Compulsive

    Oh goodie, eradication of hep C. So when are we starting regulated access to sterile injecting equipment in Australia’s prisons?

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