In another step forward to help meet WHO hepatitis C elimination targets by 2030, authorised Nurse Practitioners (NPs) can now prescribe direct-acting antivirals under the Section 100 Highly Specialised Drugs (HSD) program.

The change, effective from 1 April, also allows NPs to prescribe hepatitis B and HIV medicines.

“Enabling NPs to be eligible to prescribe Hep B, C and HIV medicines under the HSD Program is expected to improve access for vulnerable populations including patients in remote and regional areas, those experiencing homelessness, and those in custodial settings,” the PBAC Outcome statement said.

Hepatitis Australia welcomed the nurse practitioner initiative saying both hepatitis B and hepatitis C were under-treated and expanded access to timely treatment was critical.

“This important development acknowledges the clinical expertise of Nurse Practitioners and the therapeutic relationships they develop and maintain with highly stigmatised and often vulnerable populations.”

A research article in the MJA this week said Australia can meet WHO 2030 elimination target for hepatitis C “… provided treatment uptake can be sustained among people with advanced liver disease and people who inject drugs (the major group at risk of hepatitis C in Australia).”

It said treatment of HCV was cost-effective because it averts liver disease and associated health care costs.

However the authors, from the Burnet Institute and St Vincent’s Hospital Melbourne, said Australia would need to lift its level of testing given the number of treatment-ready people was declining.

Their modelling showed current levels of testing would lead to 72% of people with HCV treated by 2030 and HCV incidence reduced by 59% from 2015.

“To reach the WHO elimination targets of 80% of people with hepatitis C being treated and incidence being reduced to 80% of the 2015 level by 2030, the number of hepatitis C-exposed people identified and tested needs to be increased by at least 50%.”

“If Australia is to reach its hepatitis C elimination targets, younger people who inject drugs need to be targeted for testing and treatment.”

They suggested use of rapid point-of-care antibody tests and expanded testing in needle and syringe programs, community mental health services, and in prisons.