Is the end in sight for hep C in Australia?

Thursday, 14 Apr 2016

The hepatitis C virus could be eliminated from Australia within a decade, says a leading gastroenterologist.

The prediction from Melbourne-based Professor Alex Thompson, follows the release of new recommendations for the management of the disease.

The new Australian recommendations for the management of hepatitis C virus (HCV) infection were released in a consensus statement drawn up by the Gastroenterological Society of Australia, the Australasian Society of Infectious Diseases, the Australasian Hepatology Association, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Hepatitis Australia and the RACGP.

A summary authored by Professor Thompson, director of gastroenterology at St Vincent’s Hospital in Melbourne was also published in the MJA.

Professor Thompson wrote that the timing was right for the new recommendations in the wake of the March listing of several direct-acting antiviral (DAA) therapies for HCV by the PBS.

“The introduction of DAA therapies for HCV that are highly effective and well tolerated is a major medical advance,” Professor Thompson wrote. “All Australians living with HCV should now be considered for antiviral therapy.

He told the limbic that the PBS listing of antiviral drugs had already made a big difference to the lives of many people with hep C. He said the provision of the drugs through hospital pharmacies had been steady, and some community pharmacies have indicated their support for providing the drugs as well.

Key to this program is the move to give GPs prescribing rights, and not just limit it to specialists. However GPS have to obtain consent from a gastroenterologist, hepatologist or infectious diseases physician to prescribe the drugs. Professor Thompson said the new recommendations were designed to act as a bridge between specialists and GPs to maximise access for all patients.

“The key message is that everyone with hep C should be treated,” he said.

The consensus statement does recommend that people who are not cured by a first-line interferon-free treatment regimen should be referred to a specialist centre, while all people with decompensated liver disease, extra-hepatic manifestations of HCV, HCV–HIV or HCV–HBV co-infection, renal impairment or acute HCV infection, as well as people who have had a liver transplant should be referred for management by a specialist who is experienced in the relevant areas.

Professor Thompson said already about 150 patients from his clinic had started treatment, and to date, “it has gone very smoothly”.

The PBS listing of effective antivirals and the new recommendations have boosted his hopes that hep C could be eliminated in Australia in the not-too-distant future. Elimination is recognised when a 90% reduction in cases is achieved.

“I think it’ll take 10 years but there’s a lot of good people working towards it,” he said. “Maybe I’m an optimist but I think it’s something we can do.”

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