Affordable treatment leads to fewer deaths from hepatitis C

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There has been a 20 per cent decline in deaths from hepatitis C, new Kirby Institute data presented today at the Australasian Viral Hepatitis Conference in Adelaide shows. The decline, based on New South Wales data from more than 100,000 people with a hepatitis C diagnosis, is the first large scale evidence of the impact of new hepatitis C treatments on liver-related mortality in Australia. In the decade before new treatments were available, there had been a three-fold increase in the number of people with hepatitis C dying from liver failure and liver cancer.

Journal/conference: Australasian Viral Hepatitis Conference in Adelaide

Organisation/s: The University of New South Wales

Media Release

From: The University of New South Wales

(ADELAIDE, Monday 13 August 2018) There has been a 20% decline in deaths from hepatitis C, new Kirby Institute data presented today at the Australasian Viral Hepatitis Conference in Adelaide shows.

The decline, based on New South Wales data from more than 100,000 people with a hepatitis C diagnosis, is the first large scale evidence of the impact of new hepatitis C treatments on liver-related mortality in Australia. In the decade before new treatments were available, there had been a three-fold increase in the number of people with hepatitis C dying from liver failure and liver cancer.

Professor Greg Dore from the Kirby Institute said: “This decline reflects the high uptake of direct-acting antiviral therapies among people with hepatitis C, particularly those with more advanced liver disease. Since 2016, around 60,000 Australians have been treated with these highly curative therapies, and now for the first time, we are seeing fewer people dying of hepatitis C related causes,” said Professor Dore, head of the Viral Hepatitis Clinical Research Program at the Kirby Institute, based at UNSW Sydney.

These oral treatments first became available in 2014, but high costs made them inaccessible. Following price negotiations with the pharmaceutical companies, the Australian Government placed these treatments on the Pharmaceutical Benefits Scheme in March 2016, making them widely accessible in Australia.

“The data we’re presenting today directly relates to the estimated 70% of people with hepatitis C related liver damage that have started treatment since 2016, so we can expect to see further reductions in mortality,” said Professor Dore. “But, more broadly, only 30% of people living with hepatitis C in Australia have been treated, so we need to continue to raise awareness about these life-saving treatments.”

Australia is one of the only countries in the world to offer hepatitis C treatments at low cost, without restrictions based on a patient’s stage of liver disease or injecting drug use behaviours, and where general practitioners can also prescribe.

People who inject drugs are a key population for hepatitis C treatment and prevention, and related Kirby Institute research has shown that prevalence of active hepatitis C infection among this group declined from 43% to 25% between 2015 to 2017.

Dr Jennifer Iversen from the Kirby Institute analysed national data from people who inject drugs attending needle syringe programs and will present the results at the conference in Adelaide today.

“Over the past two years, the proportion of people who inject drugs with hepatitis C who have initiated treatment has increased dramatically, from 10% to 41%. This, combined with the reductions in prevalence of active hepatitis C infection, tells us that people who inject drugs are not only taking up hepatitis C treatment, but that they are also seeing their treatment through, and being cured of hepatitis C,” said Dr Iversen. “This is life-changing news for the individuals who’ve been cured of hepatitis C, but it has important population-level impacts, because when there are fewer people with hepatitis C infection, there is a decreased risk of transmission occurring.”

The findings on the numbers of people dying from liver disease and the burden of hepatitis C among people who inject drugs, mean Australia is in a good position to meet World Health Organisation hepatitis C elimination targets, which are to reduce deaths by 65% and new infections by 80% before 2030. Increasing treatment above current levels will achieve these targets even earlier.

The Australasian Viral Hepatitis Conference is the leading multidisciplinary viral hepatitis conference in Australasia. It is taking place in Adelaide from 13 -15 August 2018. On Sunday 12 August at a general practitioner forum held ahead of the conference, GPs pledged to raise the number of people treated for hepatitis C to over 10,000 per year by 2025.

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Stakeholder quotes:

“To have this reported decline in the numbers of people dying from hepatitis C related liver disease resulting from the new treatment is truly fantastic news, as is the increasing number of people with hep C and who inject drugs who are accessing these new direct acting antiviral treatments. However, with World Hepatitis Day just passed, we know we now need to expand greatly our efforts to get many more people living with hep C into treatment and cure. We now need to raise awareness levels and mobilise the remaining 70% of people with hep C – the people who are hard-to-reach and hard-to-engage.”

Stuart Loveday, CEO, Hepatitis NSW

“Declining deaths from hepatitis C is obviously great news for those affected and the community more broadly.  However, it is no time for complacency, with only 30% of people living with hepatitis C in Australia having been treated.  If Australia is to meet the World Health Organisation’s hepatitis C elimination targets, we will need to focus on making treatment more accessible to marginalised and at-risk groups.  This is the new challenge and the conference theme ‘No one left behind’ is designed to remind us that the mission is still a long way from being accomplished.”

Melanie Walker, CEO, Australian Injecting and Illicit Drug Users’ League (AIVL)

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