Overview

Globally viral hepatitis is a major disease burden responsible for an estimated 1.4 million deaths per year, the vast majority of these due to hepatitis B and hepatitis C. In Australia it is estimated that more than 220,000 people are living with chronic hepatitis C infection and more than 200,000 are living with hepatitis B.

The Viral Hepatitis Group works closely with virologists, immunologists and mathematical modellers to improve our understanding of hepatitis C and its transmission, and improving the management and care of people already infected with these viruses. The ultimate aim is to eliminate hepatitis C and B transmission and illness and deaths related to these viruses by 2030.

We conduct innovative studies, working closely with key affected populations including:

• people who inject drugs (PWID), the group most at risk of HCV infection in Australia
• people from culturally and linguistically diverse communities, the group a most risk of hepatitis B infection in Australia
• men who have sex with men
• the Aboriginal and Torres Strait Islander community
• prisoners.

Our work aims to reduce disease transmission of these infections and improve the detection, management and health outcomes of people already infected with these viruses.

Objectives

• To work with key affected populations to improve our understanding of hepatitis B and C transmission, risk, diagnosis and care.
• To establish surveillance systems to accurately measure hepatitis B and C incidence and prevalence in Australia
• Continue to follow cohorts of PWID with or at risk of hepatitis C using a social network approach
• Work with key national and international researchers to develop international cohorts of PWID with hepatitis C
• Work with immunologists and virologists to understand the determinants of hepatitis C primary infection, reinfection and naïve infection
• Work with health services, including The Alfred, St Vincent’s and Royal Melbourne Hospitals and community health services to develop models of care to improve hepatitis C management in PWID
• Work with health services, particularly community health services and general practitioners to improve the identification of undiagnosed hepatitis B, and the management of people with chronic hepatitis B
• Work with key national and international researchers and organisations, including WHO to develop guidelines for hepatitis B and C surveillance, testing, care and treatment.

Highlights

• Central involvement in the development of the first WHO Guidelines for Screening Care and Treatment in people infected with hepatitis C
• Completion of the Australian Trial in Acute Hepatitis C (ATAHC), which showed that PWID can be successfully enrolled and retained in HCV treatment and the successful involvement in ATAHC 2.
• The commencement of the Treatment and Prevention Study – the first study globally to examine the feasibility of using a nurse led model of care for hepatitis C treatment of PWID with new direct acting antiviral therapy, using a networks based
• The establishment of the Prime Study - using community based clinics previously established to improve hepatitis care in PWID, we will undertake a trial compared the efficacy of treamtnet in the community compared with a tertiary hospital setting.
• The use of the ACCESS surveillance system to measure hepatitis B and hepatitis C incidence and prevalence.
• The establishment of the Centre for Research Excellence in Injecting Drug Use (CREIDU)

Projects

• co-EC Study: Eliminating hepatitis C/HIV coinfection
  Eliminating hepatitis C transmission by enhancing care and treatment among HIV co-infected individuals.
• CT2 Study: Community-based Testing and Treatment for Hepatitis C
  This hybrid trial is underway in Myanmar.
• DARE C: ATAHC II Substudy
  DARE-C aims to evaluate therapy duration using triple therapy (PEG-IFN/RBV/TPV).
• EC Australia: The vital missing link to eliminating hepatitis C
  Australia’s first nationally coordinated response to hepatitis C aims to achieve elimination by 2030.
• EC Partnership: Eliminate Hepatitis C Partnership
  Informing the elimination of HCV through a community-based nurse-led model of care and treatment.
• Eliminate Hepatitis C Australia Partnership
  Bringing together researchers, implementation scientists, government, health services and community organisations to increase hepatitis C testing and treatment across Australia.
• HCV Elimination Modelling
  Providing evidence-based policy recommendations for prevention, testing and treatment of Hepatitis C.
• Healthy Mothers, Healthy Babies
  A collaborative research program aimed at providing life-saving health care for women and children in PNG.
• Identifying the barriers to hepatitis B clinical management: the perspectives of people with hepatitis B.
  This project investigates barriers to the sustained clinical monitoring and engagement of people with hepatitis B with clinical services from the perspective of people with hepatitis B.
• Identifying the structural enablers to the clinical management of people with hepatitis B in general practice: a qualitative investigation
  This research seeks to identify elements that support the provision of hepatitis B related clinical management in primary care settings.
• Rapid-EC hepatitis C Pilot Study
  Investigating the feasibility of providing rapid point-of-care testing for hepatitis C in community clinics.
• SHARP: Screening for Hepatitis in At-Risk Populations
  A collaborative project between Burnet Institute and Cancer Council Victoria.
• TAP: Treatment and Prevention Hep C study
  Does treating people who inject drugs for their hep C reduce transmission and prevalence?
• The Australian Trial in Acute Hepatitis C (ATAHC)
  An NIH-funded multicentre prospective cohort study conducted from 2004-2008 in Australia, featuring 167 subjects.
• The International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC)
  Measuring progress and identifying challenges for meeting WHO targets for achieving HCV elimination in people living with HIV.
• The Prime Study: Treating hep C in primary healthcare setting
  Examining feasibility of treating people with genotype 1 hepatitis C in primary healthcare setting.
• Understanding how HCV evades the immune system
  This project aims to understand the quality of the immune response in those people who are protected from developing chronic HCV despite frequent exposure.