Summary

  • All people living with HCV should be considered for treatment.
  • Cure or Sustained Virological Response following treatment is associated with loss of infectivity, regression of liver fibrosis and cirrhosis and reduction in the risk of liver failure and HCC.

 

 

Hepatitis C Management in Australia

At the end of 2016, there were an estimated 199,412 people living in Australia with chronic hepatitis C infection, of whom 26,270 had severe fibrosis (stage F3), 15,502 had hepatitis C‑related cirrhosis (stage F4), and 1829 had decompensated cirrhosis/hepatocellular carcinoma. 1

An estimated 32,400 individuals initiated direct acting antiviral (DAA) treatment for chronic hepatitis C virus (HCV) infection in 2016 (March-December). 2

For details on hepatitis C treatment uptake in Australia since the PBS listing of new direct acting antivirals (DAAs) from 1 March 2016, access the The Kirby Institute's (University of New South Wales) Viral Hepatitis Clinical Research Program newsletters titled Monitoring hepatitis C treatment uptake in Australia.

 

GP Management Plan (GPMP) and Team Care Arrangements (TCAs) for HCV infection

To be eligible for a GP Management Plan (GPMP), the patient in Australia must have a chronic or terminal medical condition. To be eligible for Team Care Arrangements (TCAs), the patient must have a chronic or terminal medical condition that requires ongoing treatment from a multidisciplinary team.
 
ASHM has developed the GPMP and TCAs for HCV Infection to provide GPs with best practice guidelines in the management of HCV. While this GPMP specifically relates to management of HCV, patients’ other health problems and needs are also addressed. Recommended monitoring and review guidelines are included. 

Download here the 721 GP MANAGEMENT PLAN (GPMP) for HCV infection + 723 TEAM CARE ARRANGEMENTS (TCA)

 

Direct Acting Antiviral Treatment

Effective direct acting antiviral (DAA) treatment for hepatitis C is availa​ble. In the majority of cases, chronic hepatitis C can now be cured. All people living with HCV infection should be considered for treatment.

The HCV genotype must be documented in the patient’s history to meet PBS criteria for the new HCV medicines, therefore this must be determined prior to treatment initiation. ​

 

General Statement for Drugs for the Treatment of Hepatitis C

This general statement provides the prescriber and patient eligibility for subsidisation under the PBS for hepatitis C treating agents

The hepatitis C genotype determines the treatment regimens:

 

Length of treatment (usually 12 to 24 weeks) 

 

Australian recommendations for the management of hepatitis C virus infection: a consensus statement 2017

Prepared by an expert panel, this document provides guidance on epidemiology, models of care, diagnosis, pre-treatment assessment, monitoring and treatment. It is available in various formats:

 

Form: Remote Consultation Request for Initiation of Hepatitis C Treatment

Developed by GESA-Australian Liver Association, this template can be used by medical practitioners, including general practitioners, to consult with a gastroenterologist, hepatologist, or infectious disease physician experienced in the treatment of chronic hepatitis C infection, in order to prescribe new treatments under the PBS. ​

 

Form: Obtain Specialist Approval for Initiation of Hepatitis C Treatment in 24 hours via online REACH-C form in Australia

ASHM has collaborated with the Kirby Institute on a national prospective multi-centre observational cohort study titled REACH-C (Real world efficacy of antiviral therapy in chronic hepatitis C) which aims to evaluate uptake and real world outcomes of direct anti-viral therapy for HCV in Australia. To find out more about the study, please read the REACH-C website or download the latest REACH-C Newsletter.

As part of the REACH-C study, ASHM and the Kirby Institute have developed an online form that medical practitioners can complete to gain specialist approval to initiate DAA therapy. Specialists highly experienced in hepatitis C treatment will review the data entered and either approve the treatment choice or may request that further information be provided. The anticipated turn-around time for specialist approval sought via the REACH-C online form is 24 hours.

 

Hepatitis C Education Program

ASHM supports medical practitioners in primary care to increase their knowledge and experience to enable them to prescribe treatment for hepatitis C independently. To find training near you see our Training Locator Map or for further information or support contact education@ashm.org.au

 

​References

  1. Kirby Institute. Annual Surveillance Report of HIV, viral hepatitis, STIs 2016
  2. Kirby Institute. Monitoring hepatitis C treatment uptake in Australia. February 2017