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Hepatitis C is a blood-borne virus that infects about 3% of the world’s population. It’s a significant cause of both illness and death due to cirrhosis (advanced liver scarring) and liver cancer.
By the end of 2007, an estimated 204,000 Australians had a chronic infection from the hepatitis C virus.
Given the large number of people living with hepatitis C in Australia, it’s important that we work with high-risk people in a way that makes them active participants.
Our research is a community-based project with an on-going cohort of 400 people who regularly inject drugs. This group is most at risk of infection.
We’ve been following these people regularly since 2005 – interviewing them and providing testing for hepatitis.
At the start of the project, we found that about half had already been exposed to hepatitis C. And almost one in three people still required a vaccination for hepatitis B.
Referring such people to health-care providers who can have them vaccinated is an important aspect of our work as this sub-group may not often see health-care workers.
Our field research team regularly re-interviews research participants as well as testing and counselling them for blood-borne virus transmission and prevention.
To date, our work shows that people who inject drugs are being infected with hepatitis C more frequently than previously assumed; that many carry multiple strains of the virus; and the type of hepatitis C someone has can vary and change over time.
We’ve also found that some people remain free of hepatitis C infection despite risky behaviour with infected associates.
Our ability to intensively study the immune functioning of these individuals holds promise for hepatitis C vaccine development.
The most important thing we’ve found so far is that a proportion of people exposed to the virus are able to clear it. And that some of these people can actually become infected again.
This is one of the big differences between hepatitis C and hepatitis B. Most people infected with the latter who clear the virus cannot become infected again.
How the immune system of this smaller sub-group responds is important because they indicate our prevention efforts alone won’t reduce infection rates and that current anti-viral treatments aren’t the solution.
By using this cohort, we’ve been able to explore specific research questions such as incident infection with hepatitis C; alcohol consumption and living with HCV; and participant experiences of overdose, initiation into drug treatment and experiences of recent incarceration.
And like researchers the world over working in this area, our focus is to do what we can to lower the burden of disease and costs resulting from hepatitis C.
Also published in time for World Hepatitis Day was a study by Professor Louisa Degenhardt and Danielle Horyniak. The paper, Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic review appeared in The Lancet.
CLICK HERE to read the study.