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Hep C war not over

Monday, 17th September, 2018

Doctors Funmi Kololafe, Nure Oush and Swapnil Singh of the Broken Hill Superclinic with Nurse Jo Lenton (second from right) from the Far West Local Health District. PICTURE: Callum Marshall Doctors Funmi Kololafe, Nure Oush and Swapnil Singh of the Broken Hill Superclinic with Nurse Jo Lenton (second from right) from the Far West Local Health District. PICTURE: Callum Marshall

By Callum Marshall

The number of deaths in Australia related to liver failure caused by hepatitis C has dropped by 20 per cent since 2016.

The research from The Kirby Institute at UNSW has highlighted that more Australians are now getting treated for the disease since the introduction of new drugs to the Pharmaceutical Benefits Scheme two years ago. 

Dr Funmi Komolafe at the Broken Hill Superclinic said there was a “combination of reasons” why deaths related to Hepatitis C were decreasing.

“It’s due to the new drugs introduced since 2016, but it’s also because GPs are screening more and are now able to prescribe the relevant medications and manage most of the patients through the course of their treatment within primary care settings” she said.

“In the past, patients had to be treated within specialised settings thus restricting access for some people.

“The Federal Government opened it up to GPs to drive the actual elimination of Hepatitis C in Australia by 2030, which is in line with the World Health Organisation (WHO) target.

“A whole lot of change seems to be happening and I believe it’s contributing to the reduction in death rates that we’re seeing with Hepatitis C.”

While the overall trend is positive, Clinical Nurse Consultant at the Far West Local Health District for Sexual Health and Hepatitis C, Jo Lenton, said notification numbers had recently decreased.

“While we did initially have a lot of people getting tested and treated, what we’re currently seeing are numbers going down,” she said.

“Getting people onto treatment has now slightly declined. We need to remind others out there, because we know we’ve got a pool of people who’ve got Hep C for various reasons, that they are still not accessing the services. 

“So it’s about how do we get to those people, and that’s by getting our GPs involved and reminding people again to get tested if they’re concerned they could’ve had a risk.”

Local health professionals have said part of the challenge in getting more people to be tested is about helping to break down many of the preconceptions and stigmas related to Hepatitis C, particularly related to side-effects that could have arisen in the past.

“There’s still that perception in the community that if I access Hep C treatment it’s going to be a horrible journey for me,” said nurse Lenton.

“I think it’s important to note that the treatments are very easy, one pill a day, for eight to 12 weeks, (and) that people have got a 95 percent chance of being cured.”

Dr Nure Oush of the Superclinic said: “Hepatitis C is usually associated with high risk factors like IV drug use.

“For those groups of patients it’s really very difficult to access hospital based treatment because of the prevailing stigmas associated with accessing them.

“But by decentralising to the primary health care level we can manage our patients comprehensively, not by stigmatising them in how they got their infection, but rather by advocating for them.”

GPs have also stressed that it’s important to have early discussions with them about any lifestyle or travel plans that could put you at risk of infection.

“In the last four years I have diagnosed two Hepatitis C infections, just purely because they had a high risk lifestyle or maybe had tattooing done overseas in an unsterile manner,” said Dr Swapnil Singh of the Superclinic.

“The source of infection could be anything, it’s basically a body fluid of blood contact. Sexual intercourse, or mother to child (transmission in birth), or blood transfusion that was done in the past.

“Tattooing is one of the things we come across, especially people travelling to Bali and Indonesia for holidays. A lot of my own patients, when they’re travelling, consult me. I do advise them that ‘look, if you’re planning a tattooing please make sure that it’s sterile and if not, avoid it.’”

To placate patients’ fears about Hepatitis C, GPs have said the process of getting tested is now easier than ever, particularly with the Fibro-Scan machine that measures scarring in an individual’s liver. 

“When we’re talking about the process to simplify it, people start by getting screened. If they’re positive, they get a confirmatory test and we check if they already have existing liver scarring through the Fibro-Scan at the Far West Local Health District,” said Dr Komolafe. 

“After this they get treated and experience only minimal side effects when compared to the previous interferon treatment used prior to 2016.”

Nurse Lenton said: “The Far West LHD have a visiting gastroenterologist (liver specialist), Dr Dep Huynh who we also use as a resource.

“If someone has got severe scarring or cirrhosis of their liver and their Fibro-Scan is quite high, they’re seen by her in a clinic at the hospital and reviewed as well. We have a very supportive system.”

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