Primary healthcare effort needed to achieve hep C elimination

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Burnet’s Professor Mark Stoové says hepatitis C testing rates must increase by 50 per cent for Australia to meet WHO elimination targets

Data from a progress report into Australia’s hepatitis C elimination efforts suggests the country is at-risk of falling behind global targets if testing cannot be ramped up.

In summary

  • World Hepatitis Day Symposium focuses on community-based approaches to elimination
  • Hepatitis C elimination efforts hindered by decline in testing
  • Stigma and ease of access to testing in primary care settings must be addressed to achieve elimination.

The report, discussed at Burnet Institute’s World Hepatitis Day Symposium focusing on community-based approaches to elimination, examined rates of hepatitis C testing and treatment, and modelled outcomes based on these.

Burnet Institute Head of Public Health, Professor Mark Stoové, told the Symposium that hepatitis C testing rates would need to increase by 50 per cent if Australia is to meet its World Health Organization (WHO) 2030 elimination goals.

“That equates to about 28,000 RNA tests per year, over the next decade or so. To put that into perspective, the average annual number of tests between 2016 and 2018 was a little over 23,000 nationally,” Professor Stoové said.

Professor Stoové said falling testing rates from hepatitis C have come partially as a result of a spike in testing and treatment, following the listing of direct-acting antivirals (DAAs) onto the Pharmaceutical Benefits Scheme in Australia.

“We know Australia has done extremely well since listing DAA’s on the PBS in March 2016. About 70,000 people have been treated to the end of 2018, which is one-third of the population living with chronic hepatitis C in Australia in 2016,” he said.

However he warned that testing and treating the remaining population living with hepatitis remained challenging in the current environment with issues around stigma and accessing testing and treatment in primary healthcare settings.

“This is a major area we need to overcome, in order to make people feel comfortable accessing services and disclosing that they are a person who injects drugs or that they are at risk of hepatitis C, and being recommended to be tested and treated,” Professor Stoové said.

The full report, Australia’s Progress Towards Hepatitis C Elimination, commissioned by Burnet and Kirby Institutes, will be released at the Australasian Viral Hepatitis Elimination Conference on 5 August.

“This report comes at a really pivotal time where we have made significant early progress but we really need to maintain progress over the next decade in order to met our targets,” Professor Stoové said.

Hepatitis C is a curable disease. WHO has set global targets to reduce new viral hepatitis infections by 90 per cent, ensure 80 per cent of eligible people receive treatment, and reduce deaths due to viral hepatitis by 65 per cent by 2030.

Burnet Institute World Hepatitis Day Symposium presenters

Image: World Hepatitis Day Symposium hepatitis C panel L-R: Professor Mark Stoové, Burnet Institute, Dr Alisa Pedrana, Burnet Institute, Crios O’Mahony, Penington Institute, Associate Professor Graham Brown, La Trobe University, Dr Jacqui Richmond, Burnet Institute, Professor Margaret Hellard AM, Burnet Institute, Chloe Layton, Burnet Institute, Dr Nico Clark, North Richmond Community Health, Sione Crawford, Harm Reduction Victoria, Elizabeth Birbilis, Department of Health and Human Services Victoria

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