- Hepatitis C in Australia has decreased by 58% since 2015.
- More than 100,000 Australians have received curative hepatitis C treatments.
- There were 1,740 new hepatitis C infections in 2023.
- Only 8% of people living with hepatitis C in 2023 had received treatment.
- Current hepatitis C infection among people attending needle and syringe programs has declined from 51% in 2015 to 12% in 2023.
- It is estimated that hepatitis C reinfections accounted for more than half of all transmissions.
- One in 10 people who are incarcerated in Australia have current hepatitis C infection.
- The hepatitis C diagnosis rate remained six times higher among First Nations Australians, compared with non-Indigenous Australians.
In 2023, there were an estimated 68,890 people living with hepatitis C in Australia, down 58% from 162,590 at the end of 2015, according to a new report released today by the Kirby Institute at UNSW Sydney.
“These marked reductions follow the introduction of highly curative treatments for hepatitis C in 2016,” says Professor Greg Dore, head of the Viral Hepatitis Clinical Research Program at the Kirby Institute. “Since then, more than 100,000 Australians have received curative treatment. This, alongside existing primary prevention strategies, has produced a dramatic decline in new infections.”
Estimates in the report indicate there were 1,740 new hepatitis C infections in 2023, a 61% decrease down from 4,470 in 2017 (the earliest year for which data are available).
“Since the introduction of the new treatments, we have been in an era where hepatitis C elimination may be achievable, and the data released today show Australia is tracking well towards the World Health Organization’s targets to eliminate hepatitis C as a public health threat by 2030,” Prof Dore says.
Of the estimated 68,890 people living with chronic hepatitis C at the end of 2023, an estimated 84% were diagnosed. Despite the high diagnosis and high treatment uptake in the initial years of the "elimination era", only 8% of people estimated to be living with hepatitis C in 2023 received treatment.
“The higher cure rates with the new treatments are very encouraging, however we must improve prevention, including community-led support and harm reduction programs, and increase the proportion of people receiving treatment, if we are to equitably achieve all hepatitis C elimination targets,” says Lucy Clynes, CEO of Hepatitis Australia. “Enhanced promotion and availability of hepatitis C treatments are needed, including in prisons, which remain environments of increased hepatitis C transmission. This is no longer a disease that people just have to live with. Enhanced access to prevention and hepatitis C testing and treatment is crucial.”
Declining prevalence among people who inject drugs
People who inject drugs remain a key population impacted by hepatitis C transmission in Australia. Among people who inject drugs accessing community needle and syringe programs, current hepatitis C infection has also declined, from 51% in 2015 to 12% in 2023.
“These are substantial reductions and reflect a significant decline in the level of current infection since the widespread availability of the new therapies, as well as continued access to sterile injecting equipment as a result of high needle and syringe program coverage,” says Professor Lisa Maher, author of the Australian Needle and Syringe Program Survey (ANSPS).
“This is a crucial step in the right direction for the health and human rights of people who inject and injected drugs,” adds John Gobeil, CEO of AIVL, the peer-led national peak body for people who use drugs. “However, the lack of funding for peer-based harm reduction and the criminalisation of people who use drugs are still major barriers for people accessing services and treatment for hepatitis C, especially considering intersectional stigma.”
Addressing reinfection crucial for hepatitis C elimination
The report shows that although the number of new hepatitis C infections has declined, reinfections are making up a greater proportion of new cases each year. In 2023, it is estimated that hepatitis C reinfections accounted for more than half of all transmissions (52% in 2023 compared to 30% in 2017).
“While some reinfection is to be expected, to eliminate hepatitis C in Australia, we need to increase access to needle and syringe programs and hepatitis C prevention tools, including opioid agonist therapy (methadone, buprenorphine). This is particularly important among people who are in prisons and other places of held detention, as well as among Aboriginal and Torres Strait Islander peoples, who have higher prevalence of hepatitis C,” says Prof Dore.
New data reinforces the need for prevention and testing services in prisons
For the first time, the report includes data from the first round of the Australian Hepatitis and Risk Survey in Prisons (AusHep) – a cross-sectional biobehavioural survey of people in prison in every state and territory, led in partnership by the National Prisons Hepatitis Network (NPHN). This survey shows that almost one in 10 people who are incarcerated in Australia have current hepatitis C infection. Despite this high prevalence of current hepatitis C, 85% of people in prison who are eligible reported having received treatment.
“While we’ve known for some time that the hepatitis C disease burden among people in prison is high, and we recognise that prevention, as well as testing and treatment, within prisons is crucial, we’ve previously lacked the data to understand the scale of the problem,” says Professor Andrew Lloyd, Chair of NPHN and co-lead of the AusHep study.
“To keep prisons as a high priority in the push towards elimination, we’re working closely with custodial and prison health services, along with community-based organisations, to scale-up hepatitis C care.”
First Nations Australians need culturally appropriate strategies
The hepatitis C diagnosis rate among First Nations Australians declined by 27% between 2019 and 2023. However, in 2023, the hepatitis C diagnosis rate remained six times as high compared with non-Indigenous people.
“This tells us that strategies that are effective for non-Indigenous populations are not achieving the same level of success for First Nations people,” says Robert Monaghan, manager of the Yandamanjang First Nations Health Research Program at the Kirby Institute. “There is an urgent need for culturally appropriate harm-reduction programs, co‑designed with Aboriginal and Torres Strait Islander communities both inside and outside prison environments.”