Enhancing hepatitis C treatment in the custodial setting: a national roadmap

Mina, Michael M; Clark, Paul J; Beasley, Holly M; Herawati, Lilie; Butler, Tony G; Lloyd, Andrew R

doi:10.5694/mja13.10654

Topics

Digestive system diseases

Infectious diseases

Social determinants of health

Challenges and opportunities for enhanced services

Over 300 000 Australians have been exposed to hepatitis C virus (HCV), of whom an estimated 226 700 are living with chronic infection, including 16 000 Indigenous Australians.1,2 Transmission of HCV occurs via blood-to-blood contact, most notably via injecting drug use.3 About 10 000 new infections are estimated to occur annually, and only 25% of infected individuals clear the virus during acute infection. Accordingly, the population living with chronic infection is steadily increasing.3,4 Over the next 20–40 years, about 20% of individuals with chronic hepatitis C are estimated to progress to cirrhosis,5 and thereafter 3% will die each year from liver failure or hepatocellular carcinoma.6 Chronic hepatitis C is already the leading indication for liver transplantation in Australia.4

1 Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, NSW.
2 Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, QLD.
3 Cancer Control Unit, Queensland Institute of Medical Research, Brisbane, QLD.
4 Department of Corrective Services, Government of Western Australia, Perth, WA.
5 Medical Department, MSD Australia, Sydney, NSW.
6 Justice Health Research Program, Kirby Institute, University of New South Wales, Sydney, NSW.

Correspondence: m.mina@student.unsw.edu.au

Acknowledgements:

The workshop was funded by MSD Australia, and attendees included: John Bate, Royal Adelaide Hospital; Lyn Burke, Townsville Hospital; Jacqueline Clegg, Justice and Forensic Mental Health Network; Anton Colman, Royal Adelaide Hospital; Crystal Connelly, Fremantle Hospital; Marian Croft, Western Hospital, Victoria; Peter Frost, South Australian Prison Health Service; Katarnya Gilbert, MSD Australia; Luke Grant, Corrective Services NSW; Margaret Hellard, Burnet Institute; Stuart Loveday, Hepatitis NSW; Denise Monkley, Justice and Forensic Mental Health Network; Katherine Mellor, St Vincent’s Hospital Melbourne; Jo Sexton, Princess Alexandra Hospital; Deborah Siddall, Correctional Primary Health Service, Tasmania; Poni Tongun, Marngoneet Correctional Centre; Helen Tyrrell, Hepatitis Australia; James Ward, Baker IDI Heart and Diabetes Institute; Lorraine Yap, Kirby Institute; Amany Zekry, St George Hospital.

Competing interests:

Lilie Herawati is entitled to MSD stocks as part of her employment.

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