Australia is on track to achieve hepatitis C (hep C) elimination within 10 years, having treated more than 30,000 people in 2016 – an estimated 2,450+ of whom are West Australians.1,2* This is according to a new report set for release today1 (February 21, 2017), which coincides with the availability of the latest hep C treatment, ZEPATIER® (elbasvir/grazoprevir), on the Pharmaceutical Benefits Scheme (PBS).3
The Kirby Institute’s ‘Monitoring Hepatitis C Treatment Uptake in Australia’ provides information on the initial months of the internationally-leading direct-acting antiviral (DAA) hep C treatment program in Australia.1 The number of people treated through the PBS in 2016 (an estimated 30,000 – 33,000) was 10-fold higher than recent years, representing one of the most rapid uptakes of treatment worldwide.1,4 The rapid hep C treatment uptake far exceeds the target set by the Australian National Hepatitis C Strategy to increase the number of people receiving antiviral treatment by 50 per cent each year,5 and sets Australia on the path to achieving HCV elimination within a decade.1 The report also highlights an increasing proportion of patients are being treated by general practitioners and all jurisdictions have seen an encouraging uptake.1
Dr Sam Galhenage, gastroenterologist and Head of the Liver Service at Fiona Stanley Hospital, Perth, welcomed the addition of a new treatment option to the PBS. Prior to the Federal Government’s subsidisation of new hep C treatments in March 2016, more than 230,000 Australians were living with hep C.4 If left untreated, hep C can damage the liver, causing liver scarring that can lead to liver failure or cancer.6
“Australia has a fantastic opportunity to eliminate hep C through medical intervention,” said Dr Galhenage.
ZEPATIER is now available to treat a range of people living with one of two different strains of hep C – genotypes 1 or 4.7 ZEPATIER works by eliminating hep C in the body.8 It is the first of a new class of medicines, called direct-acting antivirals (DAA), to be reimbursed on the PBS for adults living with the genotype 4 strain.3
In 1992, community educator and volunteer, Diane, 56, Perth, was shocked to learn of her diagnosis with hep C, following her earlier diagnosis of HIV in the 1980s. Struggling to come to terms with her diagnosis of a second, potentially life-threatening infection, Diane made the conscious decision at the time not to explore hep C treatment options. Twenty years later, following the introduction of the direct-acting antiviral (DAA) medications, Diane finally plucked up the courage to visit her doctor, to explore treatment for hep C.
“During my tenure with the WA AIDS Council, I learned all about hep C and the associated risks. However, I mistakenly assumed that due to my HIV, I wouldn’t be alive long enough for the hep C virus to wreak havoc on my body,” Diane said.
From the outset, Diane struggled with the emotional and physical implications of living with two potentially devastating diseases. Fortunately, throughout her journey with hep C, Diane was able to rely on the stalwart support of her close friend every step of the way.
“My friend offered to accompany me to every medical appointment, and provided invaluable support when I finally chose to seek treatment for hep C. I can’t thank her enough,” said
Diane. “Our community had been waiting for a long time for the introduction, and Government subsidisation, of the DAA treatments.”
“Providing Australians living with hep C ongoing access to effective, well-tolerated treatments will help reduce transmission of the virus, lower rates of liver disease, and eliminate hep C as a major public health issue by 2026,” Dr Galhenage said.
Despite recent progress toward elimination, Frank Farmer, Executive Director, HepatitisWA, Perth, called for heightened public awareness and urgency surrounding the need to treat,
and ultimately cure, hep C.
“Public awareness and elimination of hepatitis C are inextricably linked, which means that it is important that we engage and treat all individuals living with hep C, with a particular emphasis on marginalised people,” said Mr Farmer. “By raising awareness and providing access to medicines, we are aiming to prevent further cases of liver disease and the spread of infection.”
“Hep C can take years to show symptoms, and in the interim, can cause serious illness. Worryingly, up to 25 per cent of Australians living with hepatitis C remain undiagnosed, and may be unaware of their illness until it’s too late.”
“If you suspect you may have been exposed to hep C or are living with the virus, visit your doctor and get tested today,” Mr Farmer said.
About Hepatitis C
Hep C is a liver disease caused by HCV which is spread through contaminated blood or bodily fluids.9 There are six main genotypes (strains) of hep C.10 The most prevalent genotypes in Australia are 1 and 3.10 Hep C can cause both immediate and ongoing (chronic) hepatitis infection, ranging from a mild illness lasting a few weeks, to serious, life-long illness.11
More than 230,000 Australians are living with hep C, which, if left untreated, can damage the liver, causing liver cirrhosis, liver cancer, and liver failure.4,6 Each month, an estimated 250 Australians living with hep C develop liver disease, or liver cancer.12
All medicines have adverse effects and may impact different people in different ways. The most common adverse effects with ZEPATIER include headache, nausea, fatigue. With ribavirin: anaemia, low haemoglobin, insomnia, headache, dyspnoea, nausea, dyspepsia, vomiting, pruritus, myalgia, fatigue, asthenia. Refer to the CMI or your doctor or pharmacist for further information about ZEPATIER, what it’s prescribed for, and the possible side effects.
1. The Kirby Institute. Monitoring Hepatitis C Treatment Uptake in Australia. Available at http://kirby.unsw.edu.au/ [last accessed February 21, 2017].
2. IMS Health. Prescriptions of direct-acting antivirals for chronic hepatitis C infection in Australia.*
4. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016. The Kirby Institute, UNSW Australia, Sydney NSW 2052.
5. The Australian Government Department of Health. Fourth National Hepatitis C Strategy 2014–2017.
6. Hepatitis Australia 2014, Fast Facts on Hepatitis C http://www.hepatitisaustralia.com/information-forjournalists/. [last accessed January 13, 2017].
7. Australian Government. Pharmaceutical Benefits Scheme. Public Summary Document – July 2016 PBAC Meeting.
8. ZEPATIER® Consumer Medicine Information, August 2016. Available at https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2016-CMI-02467-1&d=2017011316114622483 [last accessed January 13, 2017].
9. Hepatitis Australia 2015, Transmission of Hepatitis C. Available at http://www.hepatitisaustralia.com/hepatitis-c-facts/transmission [last accessed January 13, 2017].
10. Thompson A 2016, Australian recommendations for the management of hepatitis C virus infection: a consensus statement, The Medical Journal of Australia, vol. 7, no. 204, pp. 268-272.
11. Holmes J et al 2013, The Right Upper Quadrant. Hepatitis C: An update, Australian Family Physician Vol. 42, No. 7. July 2013, pg. 452-456.
12. Hepatitis Australia. http://www.hepatitisaustralia.com/newsarticles/christmas-comes-early-foraustralians-living-with-hepatitis-c/19/12/2015 [last accessed January 13, 2017].