HCV Among People Who Inject Drugs in Australia

This informative session was presented by Jenny Iverson from The Kirby who oversees the Australian Needle Syringe Program Survey (ANSPS). Click here for the abstract. 

The ANSPS has been run annually since 1995 and consists of a self directed questionnaire as well as a dried blood spot (DBS) for HIV & HCV antibody testing. The survey has approximately 2000-2500 respondents yearly, with about 75% of participants residing in metropolitan areas. A number of needle and syringe program (NSP) sites are involved.  

The prevalence of HCV ab positivity had remained essentially static at 50-60% for 20 years - until the introduction of DAA therapy in March 2016. 

In 2015 the ANSPS began using DBS for HCV RNA (after a successful feasibility study in 2012). Jenny was able to discuss the recently analysed comparison data between 2015 and 2017. And the results are very encouraging. 

In summary: 

2015: 

  • 43% unexposed 

  • 12% spontaneously cleared 

  • 10% ever treated 

  • 2% cured 

  • 43% active infection 

2017 

  • 51% unexposed 

  • 12% spontaneously cleared 

  • 41% ever treated 

  • 12% cured 

  • 25% active infection 

While the above results show an impressive decrease in the number of people with active infection (and thus a decrease in the pool of transmittable virus), Jenny noted that this data is only applicable to people who are engaged with NSP programs, not the wider injecting community. She also noted that this survey does not collect SVR12 data (however with such high cure rates it is unlikely SVR12 data would alter the results).  

She concluded that surveillance remains important; to monitor success but also to identify inequity and areas to improve. This presentation was one of a number of exciting and informative sessions held on Day 1!  

 

 

Author bio: 

Dr Mel Kelly is an infectious diseases staff specialist working at The Albion Centre. She is also completing her Sexual Health Medicine Chapter advanced training. Her clinical and research interests include HIV, Hepatitis C, antimicrobial stewardship in the context of Sexually Transmitted infection and transgender health.