Rising death rates and burden of liver disease requires urgent hepatitis C treatment in people who inject or have injected drugs

Image - Rising death rates and burden of liver disease requires urgent hepatitis C treatment in people who inject or have injected drugs

Experts call for immediate access to new generation therapies for hepatitis C

(Sydney, Wednesday 7 October 2015) Treating hepatitis C in people who inject drugs is the most cost effective way to address the sharp increase in liver disease and death resulting from hepatitis C infection, new research presented at a conference in Sydney today reveals.

The research, presented at the at the 4th International Symposium on Hepatitis Care in Substance Users, has led to experts to call for immediate action to be taken to significantly improve access to treatment for the most affected population.

In Australia, several hundred people die each year from hepatitis C liver disease complications and it is the leading cause of liver transplantation. The number of Australians living with severe liver disease has doubled in the last decade. There are currently 230,000 Australians living with chronic hepatitis C, 45,000 with severe liver disease related to the diseaseand over 10,000 new cases of hepatitis C reported every year. The number of deaths related to hepatitis C infection has increased by a staggering 146 per cent in the past decade.

“Without greatly enhanced treatment access, high level hepatitis C transmission will continue, and the rising burden of liver disease will lead to substantial costs to healthcare systems,’’ said Jason Grebely, Associate Professor, The Kirby Institute, UNSW Australia. “Treatment of people who use drugs with hepatitis C saves lives and is cost-effective. We need to step up treatment access for this group as a major public health priority.”

People who inject drugs are the population most affected by hepatitis C in Australia and many other countries.Despite this, only one per cent each year receive any form of treatment. 

New interferon-free HCV direct-acting antivirals (IFN-free DAAs) can result in viral clearance in more than 90 per cent of patients in clinical trials and have the potential to reverse the rising burden of advanced liver disease and death. However treatment uptake among people who inject drugs has been constrained by poor tolerability of the older drugs, and concerns regarding adherence and reinfection.

These concerns - not supported by evidence, and compounded by entrenched stigma, discrimination and criminalisation - have led countries like the United States to exclude people who have recently used drugs or alcohol from receiving reimbursement for new HCV therapies.

Now, with new research debunking these myths, and demonstrating the cost-effectiveness of treatment among people who inject drugs, Australia has an opportunity to take an international lead. This will require the Australian government to approve the recent recommendations from the Pharmaceutical Benefits Advisory Committee, and combine treatment with other successful, evidenced-based harm reduction interventions such as needle and syringe programs (NSP) and opioid substitution therapy (OST) which have been shown to be effective in preventing hepatitis C among PWID and providing an access point to HCV testing, assessment and treatment,’’ said Annie Madden, Executive Officer of the Australian Injecting & Illicit Drug Users League (AIVL).

“Deaths and advanced liver disease associated with long term hepatitis C infection are dramatically increasing in Australia. We have not just effective but highly cost-effective therapies available to redress this situation.

‘’At the end of the day however, it is the negative impact of stigma, discrimination and criminalisation that is preventing people who need it most from accessing any kind of care in relation to their hepatitis C. This needs to change and it needs to change now,’’ she said.

“The Australian government needs to act immediately to approve these new interferon-free therapies or more people will die of entirely preventable liver disease due to hepatitis C.”

“Treating hepatitis C in people who use drugs will not only reduce the future potential disease burden and reduce costs to our healthcare system. It is also an important first step towards elimination of HCV,” said Grebely.

The call for the scale up of treatment is supported by new recommendations for the management of hepatitis C released by the International Network on Hepatitis Care in Substance Users (INHSU) today.

The recommendations are being released as part of a Special Issue on Expanding Access to Prevention, Care and Treatment for Hepatitis C Virus Infection Among People Who Inject Drugs published in the October issue of the International Journal of Drug Policy.

 

ABOUT INHSU

The International Network on Hepatitis among Substance Users (INHSU) is the only international organisation devoted exclusively to the epidemic of hepatitis C (HCV) among substance users. IHNSU is currently holding its 4th International Symposium on Hepatitis in Substance Users (INHSU 2015) in Sydney, Australia. The symposium is held biennially and was first held in Zurich, Switzerland, in 2009, Brussels, Belgium, in 2011 and Munich, Germany, in 2013.

 

This media release was prepared by INSHU. For media enquries please contact Petrana Lorenz, petrana@arkcommunications.com.au0405 158 636

 
Date Published:
Wednesday, 7 October 2015