It is estimated that there are 230,500 people in Australia who have chronic hepatitis C (HCV), of whom 15% are not diagnosed. Approximately 20% of people with chronic hepatitis C develop liver cirrhosis after about 20-30 years which may progress to end-stage liver disease and liver cancer.
Hepatitis C is caused by a blood-borne virus and is transmitted through infected blood. People who inject drugs or have a history of injecting drugs make up around 80% of existing cases of chronic hepatitis C. Infection can also come via exposure to contaminated blood products, breakdowns in infection control in healthcare, mother to child transmission, and unsafe tattooing or body piercing practices.
In March 2016, the Commonwealth Government increased access to a range of new direct acting antiviral medicines via the Pharmaceutical Benefits Scheme (PBS). These medicines offer the realistic hope of cure for many people with HCV. Without access via the PBS they would be unaffordable for most people.
The significant benefits from the new direct acting antivirals include:
- Improved cure rates (over 90%)
- activity across various viral genotypes,
- simpler oral treatment protocols
- shorter duration (12 – 24 weeks)
- activity in the presence of co-infections with hepatitis B virus and HIV
- effective in the presence of severe liver disease
- fewer side effects
This major medical advance has enabled treatment to move from intensive hospital-based therapy to community-based treatment by general practitioners in consultation with a specialist experienced in treatment of HCV. This has dramatically improved treatment uptake. Between March and May 2016 at least 5000 people with HCV commenced treatment with the new direct acting antiviral medicines.
The outcomes that can be realised through successful HCV treatment and viral eradication include:
- Improved quality of life
- Loss of infectivity
- Regression of liver cirrhosis
- Lower risk of liver failure and hepatocellular cancer
- Reduced mortality
percentage of people living with HCV in the Eastern Melbourne PHN catchment is
lower than the Victorian. However, with the potential for successful treatment
of people with HCV to lead to its eradication within a generation, screening at
risk populations and initiating treatment is a priority.
Information provided by the Population Health Information Development Unit (PHIDU) phidu.torrens.edu.au/ current at December 2015 for the calendar year.
an infographic of incidence and treatment uptake
Resources for health professionals:
C clinical pathway
HealthPathways Melbourne is an online portal which provides an up to date clinical pathway for assessment and management, plus clinical and patient resources, at point of care. Developed by GPs and medical specialists in the eastern region, it is a useful tool for GPs and other health professionals managing chronic hepatitis C. HealthPathways Melbourne assists GPs to identify at risk groups, increase screening rates and access essential resources for hepatitis C management.
Society of HIV Medicine (ASHM)
ASHM is a peak organisation of health professionals in Australia and New Zealand who work in HIV, viral hepatitis and sexually transmissible infections (STIs). ASHM provides resources and training in clinical management and research, education, policy and advocacy to support the health workforce.
- Hepatitis Victoria - provides a variety of educational resources and
valuable services to the community.
Be Free from Hep C – for health professionals
- University of Liverpool – Hepatitis Drug Interactions
Society of Australia (GESA):
Australian Recommendations for the Management of HCV Infection: A Consensus Statement 2016
Clinical Guidance for Treating Hepatitis C Virus Infection: a Summary
Resources for Consumers:
- Hepatitis Victoria – Peer Support
- Better Health Channel – Hepatitis C
- Pharmaceutical Benefits Scheme – Hepatitis C Facts for Patients and Consumers