This report provides an account of progress towards hepatitis C elimination in NSW, as framed by state, national, and global strategies. The targets and associated objectives of these strategies are to improve testing, treatment, and uptake of preventative measures for hepatitis C, and to reduce the incidence, morbidity, and mortality associated with hepatitis C. Each objective has a series of measurable indicators for monitoring progress, including a set of specific targets that evaluate service coverage and impact. The aim of this report is to describe hepatitis C elimination targets, objectives, and indicators, and the level of progress made in NSW.
- In NSW, increased uptake of highly curative hepatitis C treatment (called direct-acting antiviral therapy) has provided optimism towards achievement of hepatitis C elimination goals of reducing hepatitis C incident infections and hepatitis C-related mortality.
- Evidence indicates unchanged hepatitis C risk behaviour during the era of highly curative therapies. Further, needle syringe coverage among people who inject drugs and hepatitis C testing levels have remained high.
- Unrestricted access to new therapies has provided remarkably equitable uptake, with indications that higher-risk (generally more marginalised) populations in fact have had higher uptake than the broader hepatitis C population.
- There is early evidence that stable hepatitis C risk behaviour and high initial treatment uptake is leading to reductions in new hepatitis C infections. Further, advanced liver disease burden, which had been progressively escalating rising before advent of new therapies, is now in decline.
- Despite these encouraging findings, there are relative gaps for some hepatitis C sub-populations in service and impact measures, including high levels of stigma and discrimination and lower treatment uptake among females, people born overseas, and Indigenous populations with recent drug dependence and recent incarceration.