Kirby Institute releases report on progress of hep C elimination in NSW
The uptake of direct acting antiviral (DAA) hep C treatments in NSW has meant there is a promising prospect for achieving the goals of reducing the incidence of hep C infections and deaths according to a recently released report from the Kirby Institute.
The Hepatitis C Elimination in NSW: Monitoring and evaluation report 2019 identifies progress towards elimination in NSW. It has been developed to report against NSW, Australian, and global strategies. Specifically, the report looks at NSW progress in improving the testing, treatment and uptake of preventative measures for; as well as reducing the occurrence, incidence and deaths associated with, hep C.
In addition to the positive outlook for elimination of hepatitis C, the report found that unrestricted access to treatment – as provided for by the PBS guidelines – has resulted in a very broad community uptake, with indications that people who might be at higher-risk (that is, usually also more marginalised) have had a higher uptake than the broader population of people living with hep C.
According to the report, there is evidence that stable “hep C risk behaviour” and high initial treatment uptake is leading to reductions in new hep C infections. Furthermore, the number of people with advanced liver disease, which had been growing before the arrival of the new cures, is now on the way down.
Despite these encouraging findings, the report notes there are relative gaps for some hep C sub-populations in service and impact measures. There are still high levels of stigma and discrimination and lower treatment uptake in many of the areas of the community – notably among women, people born overseas, and Aboriginal and Torres Strait Islander people; especially where there has also been recent drug use or recent imprisonment.
Hepatitis NSW welcomes the report’s findings and, while it offers considerable encouragement that elimination of hep C in NSW is possible, it still highlights a number of areas that require continued effort to address shortfalls. Hepatitis NSW will continue to work with our community and all other stakeholders to ensure the elimination of hep C in NSW.
To read more and to download the report >>>CLICK HERE
COVID-19 and viral hepatitis FAQs are go!
Over the last month, Hepatitis NSW has been fielding a range of enquiries – via our Hepatitis Infoline, our web chat, and email – from people concerned about the impact COVID-19 might have on them due to their past or present lived experience with hep C, hep B and/or liver disease.
Since the COVID-19 virus is so new and can be life threatening, there are many unknown factors at play. This is even more so for people with pre-existing health conditions to consider. To help address those concerns and to answer the frequently asked questions, Hepatitis NSW has now compiled a number of online resources:
- COVID-19 and hep C FAQ webpage
- COVID-19 and hep C FAQ PDF
- COVID-19 and hep B FAQ webpage – also in Chinese and Korean
- COVID-19 and hep B FAQ PDF – also in Chinese and Korean
All pages are based on the most up to date information and will be updated frequently.
- The hep C FAQs cover: Hep C and COVID-19; Hep C treatment and COVID-19; Drug use and methadone; COVID-19 and other risks; Liver health and COVID-19; COVID-19 virus and illness
- The hep B FAQs cover: Hep B and COVID-19; Hep B treatment and COVID-19; Hep B vaccination and COVID-19 (people NOT living with hep B); COVID-19 and other risks; Liver health and COVID-19; COVID-19 virus and illness.
Please pass the links along to anyone you know who would find the information useful.
Hepatitis NSW: A snapshot of state-wide DBS collaborations
Live Hep C Free is one of Hepatitis NSW’s flagship programs. The program is focused on making access to healthcare as simple, quick and barrier-free for people living with or at-risk of hep C to access hep C healthcare.
Our NSW-wide team of expert hep C peer workers (people who have experience of living with hep C) work to facilitate access to on-site healthcare in priority settings – residential rehabs, homelessness services, opioid treatment program (OTP) clinics and drug health services, mental health services, community health settings, and outreach settings.
We work with clinical partners across NSW, primarily hepatology nurses, to provide hep C healthcare. Peer workers not only encourage access to on-site healthcare but also offer on-treatment and post-treatment support, persistence in addressing client’s hep C needs, reminders to clients from the nurse, dispelling of myths about treatment, and work to reduce hep C stigma in a service.
Dried blood spot testing (DBS) has become an important addition to the Live Hep C Free program’s efforts to make hep C health as simple and easy to access as possible. DBS has been an option at our longest running outreach sites in Sydney Local Health District – Clinic 36 and Garden Court private OTPs from the start.
Since July last year, the Live Hep C Free program has been delivered in ten LHDs in NSW: Sydney, South Eastern Sydney, South Western Sydney, Western Sydney, Central Coast, Hunter New England, Mid North Coast, Northern NSW and Western and Far Western NSW. Illawarra Shoalhaven and Northern Sydney LHDs were on the cusp of commencement before the COVID-19 shutdown. Approximately 70 service visits have had DBS testing on offer. Where DBS is offered alongside traditional blood draws approximately 10-30% of clients access DBS testing, depending on various factors it can be as high as 80% and 50% is common.
Peer workers work in close partnership with clinicians. They have a great grasp of DBS, and they talk about it being an option to clients of the services. Peers do a great job of explaining when DBS is best for clients. Such as, if they have poor venous access or have concerns about having blood drawn. Peer workers are also well equipped to talk about when it might be better for people to just get a blood draw.
What do the experts say?
“As far as I am concerned as a peer worker in this environment the fact that we can offer a finger prick option to clients as opposed to a potentially difficult and or upsetting session of vein access is a wonderful and often well received option.” Justine Doidge, Project Officer Community Support, Hepatitis NSW
“…as a clinician and experienced venepuncturist, I always prefer and have capacity to offer broader screening blood tests than HCV + HIV in the same short period of time that DBS takes. However, I can see that for some people in my setting that DBS is useful e.g. for SVR check if have already had blood tests and/or for annual retest if patient has veins that are difficult to access. And in the broader community for HCV screening where there are staff engaging clients re HCV who don’t have on site or immediate access to venepuncture expertise, that is definitely an ideal setting for it.” Sinead Sheils, Nurse Practitioner, SLHD
Four Hepatitis NSW peer workers have training in DBS and so can assist clients in getting a DBS test. In the future we aim to have all our peer workers trained in DBS to support nurses/services and increase their capacity.
The Live Hep C Free program is currently on hold due to COVID-19 pandemic but we plan to restart the program as soon as it is safe to do so. We certainly hope that time is sooner rather than later so we can once again support people living with or at-risk of hep C to access testing and treatment. DBS will certainly continue to be an integral part of hep C screening and the Live Hep C Free program, with number of DBS tests expected to increase as we emerge from COVID-19 restrictions.
Any means of increasing and supporting clinical capacity to increase hep C testing and treatment at this time and into the future is vitally important.
Test Cure Live campaign winner: “Hep C treatment and cure is excellent news”
Congratulations to Karen, the winner of our Northern Rivers NSW Test Cure Live campaign competition. Karen won a Weber Baby Q as part of a local letterbox drop to raise awareness of the highly effective hep C treatments and cures. Karen, seen left, collected her prize from the Lismore Liver Clinic.
Entrants needed to correctly answer some hep C questions, based on the information in the leaflet left in their mailbox. In addition to getting a top score, Karen wrote “excellent news” on her entry, and we couldn’t agree more!
You can find out more about the Test Cure Live campaign in the Northern Rivers on the website >>>CLICK HERE