ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
HCV Elimination by 2026
Satellite Session:
Fantastic expert panel presentation informally discussing reality of target and inviting audience participation
Consensus a Challenging target
Possible to eliminate as Public Health threat if role out of new treatment continues
Treat as prevention to decrease new infections
Do need vaccine as resistence possible
Possibly Realistic target have the tools, systems, funding
Need to ENGAGE people
Large population of HCV , it is not their priority
greater 40,000 treated by end year but many still not aware treatment availability, also ageing population
Need GP's to take up treatment
need to test, need good history taking ,use database
Remember STIGMA prevents accessing GP
need to increase training for GP's in Hep C and treatment
Open treatment landscape
Move out of Hospital specialist, GP could use if not got skill set
Target will need massive investment for Aboriginal Medical Services
15-24 ages :Indigenous 8x higher Hep C rates
Increasing IVDU under acknowledged
And Prison
Will need sysrems to monitor who is on treatment
think treatment as prevention, frame positively, can cure
Solid plan to include Primary care, main contact point for Indigenous population
HIV coinfected treat early, care re reinfection but Caution STIGMA
Remember DDI, be aware
HCV and HIV VL not an issue
BUT noted easy for the experts to say need to role out updated info and guidelines for GPs
Reinfection main risk Prisons
Discussion around barriers to OCT (opiod substitute therapy/methadone)
Difficult to access in prisons....THE DIFFICULT area despite funding
NEED SAFE INJECTING PRACTICES and regulated needle exchange
30% Indigenous in prisons including youth
SA making inroads re strategy
Reminder Indigenous mobility
Suggests Research grant re what it would take to get to target in Indigenous population
Cairns area low IVDU BUT caution change
Prison Mareeba attitude to treat prompt and often
Remember to look GLOBAL
Reminder of costs and increasing problem crystal meth
Problem HePC treatment still mainly metropolitan area
Need strong GP networks
Resistence in initial HCV regimes not a problem if Fail may need 2nd line
Need traditional Public Health approach
Indigenous population need treatment as prevention and to hear benefit of cure
Discusion re HIV group take on HCV as experienced
Need to be realistic, limited specialists,liver clinics problematic
Use of NPs
Need to be able to write prescriptions....in the pipeline
Overall consensus came at role out was backwards
Ivory Tower Not as Public Health problem
Approach should have been:
ASSUME population dont know
Hep C much more prevalent
GET tested
Treatment can cure
Access to clean needles
Implement systemic changes in Primary care
Who are pos
Who is on treatment,adherence
Chronic care plans......
Overall great opportunity to see where the new treatment role out is at with a target date set for HCV elimination...
and opinions at what needs to be done
Highlighted the continuing shame to ignore Indigenous population requirements,
We once promoted safe injecting,needle exchange....
The title Australia leads the world is not deserved until it is truly inclusive to its Indigenous population needs