The presentation by Professor Dore was a rapid but detailed overview of the situation of the current situation with Hepatitis C and how things have progressed over the past two years with the introduction of the Direct Acting Antiviral drugs since 2015, and more particularly, the subsidisation of these medications on the Australian Pharmaceutical Benefits Scheme in March 2016.
Professor Dore is the head of the Viral Hepatitis Research Program at the Kirby Institute at the University of New South Wales, and an Infectious Diseases Physician at St Vincent’s Hospital in Sydney.
The Real world efficacy of antiviral therapy in chronic hepatitis C (REACH-C) in Australia research report is published by his team.
He emphasised the impact of these medications as safe, effective and well tolerated drugs, in contrast to those previously available. The availability of these drugs almost without restriction to eligible patients has made a major impact on both and individual and population level. With almost a quarter of a million patients in Australia living with Hep C, knowingly or otherwise, the possibility of eliminating Hep C as a major public health issue in Australia is an achievable aim by 2026 to 2030.
Over 32,000 people were treated between March and December in 2016, representing 14% of those effected. However, figures for 2017 show declining numbers being treated compared to last year. The figures are still encouraging for people in “at risk” groups including this with Cirrhosis and those who inject drugs, and post treatment follow-up requires enhanced efforts.
Professor Dore went on to compared the “real world efficacy” of the DAAs in various situations and spoke of the REACH-C trial observational cohort, and compared the different efficacies of the different DAA regimes, and genotypes of Hep C. Various diverse models of care delivery in different situations were then discussed. Modelling of Hep C elimination in different scenarios (Pessimistic, intermediate, and optimistic) were given.
In summary, it was concluded that: Australia is leading the world in treating Hep C with DAAs, key populations for the elimination of Hep C are being reached, outcomes are favourable despite some failures in followup, and to reach the goals set by WHO, bradened models of treatment delivery are required over the next two to three years.
Professor Dore is Head, Viral Hepatitis Clinical Research Program, Kirby Institute, UNSW, Sydney Australia, and Infectious Diseases Physician, St Vincent’s Hospital, Sydney, Australia. He has been involved in viral hepatitis and HIV epidemiological and clinical research, clinical care and public health policy for 20 years.