The latest edition of IMPACT looks at Burnet Institute’s world-first Treatment as Prevention (TAP) Study, which directly targets those at greatest risk of hepatitis C infection, people who inject drugs.
Below is an excerpt of that article which you can view online or subscribe today!
Hepatology medicine has reached a watershed that could result in the elimination of hepatitis C virus (HCV) in Australia within 15 years, thanks to the availability of new direct-acting, all oral drugs and changes in treatment.
Head of Burnet’s Centre for Population Health, Professor Margaret Hellard believes hepatitis C treatment and prevention presents an unprecedented opportunity to eliminate HCV in Australia, and reduce harms and costs. The TAP Study is examining the feasibility of this approach.
“There is stigma and discrimination against people infected with hepatitis C, and the populations who are at risk of hepatitis C,” Professor Hellard said.
“But if treatment can be delivered effectively to high-risk transmitters such as people who inject drugs, significant reductions in future hepatitis C cases are possible.
“A treatment and prevention approach gives us the opportunity to eliminate the virus by treating people infected with hepatitis C for their own direct health benefit who are missing out now, and at the same time stopping ongoing transmission of the virus.”
Conducted in collaboration with St Vincent’s Hospital and The Alfred hospital, TAP will assess the feasibility of community-based treatment, and whether treatment and prevention can reduce hepatitis C transmission and prevalence.
TAP Study participants infected with hepatitis C will be treated with new medications, sofosbuvir and ledipasvir, made available through a multimillion-dollar grant by Gilead Sciences. Both drugs have been approved in the USA and are now licenced in Australia, but not yet subsidised under the Pharmaceutical Benefits Scheme.
Trials indicate sofosbuvir and ledipasvir are highly effective with cure rates better than 95 per cent, can be taken for a shorter duration, and are well tolerated with minimal side effects.
Because these new HCV medications require less specialist expertise than existing treatments, this presents an opportunity for new models of care and the prospect of treating PWID without them having to attend a hospital service.
“Attending a large hospital or health service has commonly been a barrier to care for people who inject drugs,” TAP Clinical Director, Dr Joseph Doyle said.
“But they are comfortable being treated in a community setting by clinicians, and other support services, they know and trust. TAP addresses this by providing nurses to treat and monitor participants in outreach vans and clinics located in their local communities.
“To eliminate hepatitis C in Australia, we have to work out how to use these new medications sensibly in community settings to reduce the disease transmission.”