Australia is on track to eliminate hepatitis C in ten years if record numbers of people living with the virus continue to seek and receive breakthrough antiviral treatment, according to a new analysis released on World Hepatitis Day.
Data from the Kirby Institute at UNSW Australia reveals that since new generation hepatitis C cures were made available on the Pharmaceutical Benefits Schemes five months ago, 22,470 Australians have already commenced treatment – a massive increase on the 2,000-3,000 people with hepatitis C treated annually prior to the listing.
Professor Greg Dore from the Kirby Institute said, “Australia is leading the world in the treatment of hepatitis C, with the most rapid uptake of new treatments seen anywhere in the world, thanks to the unique approach Australia has taken in making these medicines available without restriction.
“This represents a huge leap forward in public health. To put this into perspective, we are on track to cure more people with hepatitis C this year than in the past twenty years of interferon-therapy,” he said.
Hepatitis Australia CEO, Helen Tyrrell said that the wave of people who had been treated was “frankly phenomenal” but that Australia must keep up the momentum in order to make the elimination of hepatitis C a reality within a decade in Australia.
“Governments, along with the health and community sector, should be applauded for the record number of people with hepatitis C coming forward for treatment so far, but of course these efforts must be sustained over many years to reach everyone who would benefit,” Ms Tyrrell said.
“The message for the 230,000 Australians living with hepatitis C is: Ask your doctor about new hepatitis C cures. Don’t miss out. You can be cured in as little as 12 weeks and with far fewer side-effects than previous treatments,” Ms Tyrrell urged.
The Department of Health estimated that 62,000 people would be treated with the new antivirals in five years, however if high treatment rates continue, experts believe this goal could be reached by the end of 2017. Importantly, there is no limit on the number of patients that can be treated.
“This is a huge achievement and testament to the critical role of GPs who can prescribe hepatitis C medicines for the first time – and the vision of the Australian Government in making these therapies available without restriction,” Ms Tyrrell explained.
“The great news for the public purse is that the amount of money paid for these medicines is capped, so the more people treated over the next five years the better,” she said.
Professor Greg Dore said, “Treatment for hepatitis C is vital to prevent liver damage which can lead to liver cancer, liver cirrhosis and liver failure – and treatment is now better and easier than ever.
“If you’ve ever been exposed to the hepatitis C virus, or if you’ve been told you’re living with the virus, speak to your doctor about a liver check-up and make sure you benefit from the new cures,” Professor Dore said.
Hepatitis Australia is also using World Hepatitis Day to urge governments to make similar strides in combatting hepatitis B. It is estimated nearly half of the more than 213,000 people living with the virus remain undiagnosed and only around 5 per cent are currently receiving treatment.
“It’s tragic that so few people living with hepatitis B are being appropriately managed and treated, as it puts them at heightened risk of liver cancer,” said Ms Tyrrell.
Associate Professor Benjamin Cowie from the Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity said, “While there is no cure as yet for hepatitis B, we can prevent serious liver damage and complications including liver cancer caused by hepatitis B infection, provided people can access appropriate monitoring and treatment."
“However, nearly one in two people don’t yet know they are living with hepatitis B and over 80 per cent of Australians living with hepatitis B are not receiving the care they need."
“People sometimes think that if they have no symptoms then they don’t need to see their doctor, but often symptoms of long term hepatitis B infection only appear when it’s too late – when the liver is already severely damaged,” he said.
“We therefore encourage everyone with hepatitis B to speak to their doctor and receive a regular liver check-up to protect themselves against serious liver disease,” Associate Professor Cowie concluded.
Hepatitis Australia said that while Australia is leading the world in hepatitis C, there is more to do in hepatitis B and is calling for Australia to “step up the national response to hepatitis B to ensure that the quarter of a million Australians living with hepatitis B are not left behind”.
“The tremendous gains made with hepatitis C show that where there is a will, there is a way. Australia must accelerate efforts to vaccinate, monitor and treat hepatitis B as we work towards the global elimination goals,” Ms Tyrrell said.
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About hepatitis B
Affecting more than 213,000 Australians, hepatitis B is transmitted through blood-to-blood contact or unprotected sexual contact. Without appropriate management and timely vaccination for infants, a pregnant woman with chronic hepatitis B can transmit the virus to her baby.
While vaccination rates are high among people born in Australia since the year 2000, they remain low among many people born overseas. Hepatitis B is endemic in the Asia Pacific region and in sub-Saharan Africa. There is also a higher prevalence of hepatitis B in Aboriginal and Torres Strait Islander people.
The best protection against hepatitis B is to get vaccinated. For those living with chronic hepatitis B, ongoing monitoring and treatment provides the best protection against the development of liver disease and liver cancer. However, only around five per cent of people with hepatitis B are currently receiving treatment, and less than 20 per cent are being monitored according to guidelines.
About hepatitis C
Affecting more than 230,000 Australians, hepatitis C is transmitted through blood-to-blood contact. Approximately 80 per cent of current infections and 90 per cent of new infections are thought to result from unsafe injecting drug use. Hepatitis C can also be contracted through unsafe tattooing and body piercing practices and from mother to baby. Serious liver disease related to hepatitis C claims hundreds of Australian lives each year.
There is no vaccine to protect against hepatitis C but the infection can be treated and cured in nine-in-ten people with the most common genotypes. New interferon-free therapies which became available without restriction from 1 March 2016 have exceptionally high cure rates exceeding 90 per cent, shorter treatment durations and far fewer side-effects than the older treatments.
New treatments have led to a significant increase in the number of people treated. Previously, only one per cent of people living with hepatitis C were treated each year. Low treatment rates were blamed on the toxicity associated with the older treatments.
Global elimination goals
The Global Health Sector Strategy on Viral Hepatitis was adopted by the World Health Assembly in May 2016, this sets the goal of eliminating viral hepatitis as a public health threat.
Global Targets include:
- 90% reduction in new hepatitis B and hepatitis C infections by 2030
- 65% reduction in deaths from hepatitis B and hepatitis C by 2030
- 90% hepatitis B childhood vaccination coverage by 2020 (and sustained to 2030)
- 90% of those with hepatitis B and hepatitis C diagnosed by 2030
- 80% of those living with hepatitis B and hepatitis C treated by 2030