More support needed to cut HCV toll

Despite effective therapies and government subsidies for treatment, only a minority of people in Australia who are infected HCV have been treated.

Researchers used data collected from a network of 24 HCV clinics across Australia between April 2008 and December 2009 to determine how many patients undertook treatment and which patients were more likely to defer treatment.

Of the 406 newly-assessed patients studied, only 42 per cent commenced treatment within six months of first enrolling at the clinic, Ms Heather Gidding of the Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research) at the University of New South Wales said.

While the most common reason given for deferring treatment was that the patient was still in the initial stage of the assessment process, almost one in four of those recorded as deferring treatment did not return for follow-up after their first visit.

“Factors related to drug and alcohol use were the only factors significantly associated with deferral of treatment in our study,” Ms Gidding said.

“Of the 406 patients in the analysis sub-cohort, 165 (41 per cent) had at least one of the factors related to drug and alcohol use that were found to be independently associated with treatment deferral.”

It could be that the health care provider wanted to stabilise the patient’s drug or alcohol dependency before commencing treatment, or was reluctant to treat a former injecting drug user because of a perceived risk of relapse, she said.

“Despite these concerns and our findings, there is limited evidence to suggest that outcomes of treatment for HCV are worse for patients being treated for drug dependency and currently using injecting drugs,” Ms Gidding said.

“Improved co-management of drug and alcohol dependency together with enhanced infrastructure for the delivery of HCV treatment should enable increased uptake of treatment for HCV at the population level and reduce the morbidity associated with this disease.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACT:         Ms Heather Gidding                             02 9385 0965 / 0408 227 133

                        Mr Steve Offner                                   02 9385 8107 / 0424 580 208

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