Hepa­titis ­C in Australia: 2024 statistics

Rates of new hepatitis C infections have steadily declined since 2016. This is seen through reductions in incidence among people attending primary care clinics and a sample of people who inject drugs.

Since 2016, there’s been a decline in hepatitis C virus (HCV) ribonucleic acid (RNA) prevalence among a sample of people who inject drugs. HCV RNA is the genetic material of the hepatitis C virus found in a person’s blood.

Data from this year’s report show other promising signs, with increased testing seen in some settings including:

• primary care
• sexual health clinics
• Aboriginal Community Controlled Health Services.

There remain areas for improvement:

• Data from the Australian Hepatitis and Risk Survey in Prisons indicates gaps in recent testing coverage.
• Cascades of care from community settings suggest some people were not engaged in care and treatment following their diagnosis. Community settings include primary care clinics and Aboriginal Community Controlled Health Services.

Cascades of care are the stages a patient goes through to receive care, from diagnosis through to treatment and management of disease (Subbaraman et al., 2019).

Hepatitis C treatment increasing

For the first time since 2016 there was a year-on-year increase in the number of people receiving treatment (in 2023 compared to 2022).

• Between 2016 and the end of 2023, 105,940 individuals had been treated for hepatitis C (first treatment). This included 5,499 people starting treatment in 2023.  
• In 2023, 42% of people who started hepatitis C treatment, started in prisons. This continues to represent a large and increasing proportion of all treatment initiations nationally.
• Since 2016 there have been 13,465 prescriptions for retreatment.

Declines in hepatitis C‑related transplants demonstrate how direct‑acting antiviral treatment reduces the risk of developing liver disease and liver cancer.

Challenges in eliminating hepatitis C

There are challenges in progress towards elimination. Modelling estimated that there remained 68,890 people living with hepatitis C at the end of 2023.

Over 100,000 people have been cured of hepatitis C. As this population continues to grow, we need to monitor people’s liver health, particularly by checking for liver cirrhosis, a key risk factor for liver cancer. This report highlights that stigma and discrimination towards people at risk of, and living with, hepatitis C is prevalent.

Importance of preventing hepatitis C 

This report highlights that primary prevention must remain a critical component of the response to hepatitis C and be strengthened. Up to 20% of people who inject drugs surveyed in 2023 reported borrowing needles or syringes. This is the primary method of hepatitis C transmission. Geographical data shows variation in treatment coverage, highlighting that equity must be at the forefront of the response to hepatitis C.

Actions to reach hepatitis C elimination by 2030

If Australia is to reach elimination by 2030, a range of interventions are urgently needed.

Health promotion campaigns are needed to ensure priority populations are aware that hepatitis C treatment and retreatment is available to them and to encourage them to engage in care.

Models of care need to be tailored to reach priority populations and provide wrap‑around or flexible services that support effective linkage to care.

A focus needs to be on engaging people within priority settings including:

• drug treatment services
• needle and syringe programs
• services for people experiencing unstable housing
• community corrections
• prisons.

Given the success of scaling up testing and treatment models in prison, resources should be allocated to broaden the reach of these programs. This should be done across the justice system, including remand centres and community corrections services. This approach would ensure these priority populations have equitable access to hepatitis C care.  

Ongoing investment is also needed to stop new infections, including in prisons, using the full suite of harm reduction programs.

Continued efforts to address stigma and discrimination related to hepatitis C and injecting drug use are needed. Services can better support people living with hepatitis C by providing person‑centred care. This kind of care recognises people’s experiences of stigma, trauma and racism, and focusses on social, cultural, and emotional needs, as well as medical needs.  

Alongside expanding models of care to reach priority populations, ensuring the workforce is adequately trained and equipped through education and skill development is critical to deliver appropriate care for people living with hepatitis C.