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Management and Treatment

​​​​Summary

  • It is recommended all people with chronic HCV are seen by their doctor every 6 to 12 months as it is important to regularly assess for liver disease progression and address any comorbidities that may be present.
  • Chronic HCV infection can cause long term liver disease, including cirrhosis and hepatocellular carcinoma (HCC).  ​

Hepatitis C Management in Australia

There were an estimated 230,000 people living in Australia with chronic hepatitis C infection in 2012, including 58, 000 with moderate to severe liver disease. 1

The estimated number of people receiving treatment for hepatitis C through the Highly Specialised Drug Program declined from a peak of 3,397 in 2009 to 2,360 (1%) in 2012.2


Direct Acting Antiretroviral Treatment

Effective direct acting antiretroviral (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. ​

The hepatitis C genotype determines the:

  • Treatment regimens
    • ​For genotype 1​ sofosbuvir + ledipasvir or sofosbuvir + daclatasvir ± ribavirin
    • For genotype 1​ – paritaprevir-ritonavir + ombitasvir + dasabuvir ± ribavirin
    • For genotype 2 – sofosbuvir plus ribavirin
    • For genotype 3 – sofosbuvir plus daclatasvir or sofosbuvir plus ribavirin
    • For genotype 4-6 – There are no IFN-free treatment regimens currently available on the PBS in Australia 
  • Length of treatment (usually 12 to 24 weeks)
  • Treatment response

HCV treatments are evolving rapidly with the introduction of direct-acting antiviral (DAA) drugs. These new treatments offer significant clinical benefit with SVR rates greater than 90%, low toxicity and shortened treatment duration.

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Australian recommendations for the management of hepatitis C virus infection: a consensus statement 2016

Prepared by an expert panel, this document provides guidance on epidemiology, models of care, diagnosis, pre-treatment assessment, monitoring and treatment. For full details, see the Australian recommendations for the management of hepatitis C virus infection: a consensus statement 2016 at www.hepcguidelines.org.au


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. ​


New hepatitis C treatments factsheets listed on the PBS

See also the General Statement for Drugs for the Treatment of Hepatitis C to determine patient eligibility for subsidisation under the PBS for hepatitis C treating agents

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List of Community Medical Practitioners trained and experienced in the treatment of chronic hepatitis C infection.

View a list of Community Medical Practitioners trained and experienced in the treatment of chronic hepatitis C infection effective August 2016 here

 


Hepatitis C Education Program

​​​​ASHM is working to increase the capacity and confidence of primary care practitioners to diagnose, manage and treat people living with hepatitis C

ASHM receives funding from the Commonwealth Department of Health and Ageing to convene the National HCV Training Standards Committee which develops and endorses national curriculum and training materials and liaises with relevant state and territory jurisdictions for their implementation. 


Resources

There are a number of practical and clinical resources available to support your work with hepatitis C. These include the booklets GPs and Hepatitis C; Antenatal Testing and Blood-borne  Viruses; Nurses and Hepatitis C; and Dentists and Hepatitis C.

We have also produced a range of profession-based booklets for Emergency Services, Corrective Services Officers, Police Officers, as well as access to third-party resources and fact sheets for clients and patients. Please visit the resources page for the full catalogue.

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References:

1. Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013.

2. Fourth National Hepatitis C Strategy 2014-17. Australian Government Department of Health.

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