The number of Australians dying from hepatitis C liver failure and liver cancer has fallen 20 percent in just two years, according to preliminary data released today by the Kirby Institute.
It follows the introduction of highly effective, cost-effective remedies for the Pharmaceutical Benefits Scheme (PBS) in 2016.
"This decline reflects the high prevalence of direct-acting antiviral therapies in people with hepatitis C, especially in patients with advanced liver disease," said Greg Dore of the Kirby Institute.
"Since 2016, around 60,000 Australians have been treated with highly healing therapies, and for the first time we see fewer people dying from hepatitis C disease."
The data also showed that the prevalence of hepatitis C infection in people currently injecting drugs has dropped from 43 percent in 2015 to 25 percent in 2017.
"It's a tremendous step forward in trying to control the epidemic," said Professor Dore.
However, it is estimated that 170,000 people still live with chronic hepatitis C in Australia.
Recent data show that the introduction of life-saving antiviral therapies was initially strong. However, less than half of people now depend on the medication, as was the case in 2016.
Helen Tyrrell, chief executive officer of Hepatitis Australia, said the recent decrease in treatment was "a real problem" and many people were unaware of the benefits or availability of new treatments.
"It's a tragedy that hundreds of thousands of Australians are missing life-saving therapies that can cure hepatitis C in a few weeks … if those remedies are available on prescription," said Tyrrell.
New treatments 95pc effective
While hepatitis C treatments have been available for some time, previous therapies were "very long," "very grueling," and "not so effective," Tyrrell said.
"What changed in March 2016 was fantastic new healing methods, it was a real revolution when the government agreed to bring them to PBS for everyone in Australia," she said.
The new treatments, consisting of daily tablets for approximately eight to twelve weeks, are generally well-tolerated and cure hepatitis C in 95 percent of people.
Before being admitted to the PBS, the drugs cost more than $ 20,000. They now cost less than $ 40 and can be prescribed by general practitioners, eliminating the need for specialist treatment.
"Having a GP visit to these treatments is fantastic because it gives people the opportunity to get in touch if they are a bit reluctant due to the stigma," said Tyrrell.
Australia is one of the few countries in the world to offer low-cost hepatitis C treatment without any restrictions due to liver disease or injecting drug use, said Professor Dore.
"Australia has done a great job in the first two years … but only 30 percent of people living with hepatitis C in Australia have been treated, so we need to continue to raise awareness about these life-saving treatments," he said.
Reaching marginalized communities
Professor Dore has said for many people that a diagnosis of hepatitis C is often linked to a complex set of health and social problems.
Hepatitis C disproportionately affects Aboriginal people and Torres Strait Islanders, people who inject drugs, and people who are detained.
"That's why we need more innovative strategies to reach populations that are more marginalized."
A lack of awareness on the part of both patients and health professionals has resulted in low levels of treatment in some parts of the community, Tyrrell said.
"Many people may still not be aware of the new treatments, and people who were diagnosed 20 or 30 years ago – if there were really no treatments – may have been told to go home and not worry," she said ,
"Then you have people who just do not prefer treatment because they have no symptoms, and that's really dangerous … because often symptoms develop when serious complications occur."
Ms. Tyrrell stressed that it is important for general practitioners to prioritize hepatitis C testing and treatment and "start talking to people they know may be at risk."
Sydney man Grenville Rose fell ill with hepatitis C in the late 1970s and lived with the virus for almost 40 years before being successfully treated with the new, highly healing oral therapies in 2015.
"I was lucky enough to have the support of friends and family, but that's certainly not a universal experience for people with hepatitis C," he said.
Grenville said many people are faced with stigma and discrimination when they disclose or discuss their illness with family, friends or healthcare professionals.
"I've heard some really horrible stories," he said.
Ms. Tyrrell said that this stigma continues to be a major barrier to people seeking treatment today.
"Sometimes it's really disappointing to get that attitude," she said.
"Hep C is a health condition like any other, it does not matter how you got it – the important thing is that people get healed."
Australia on its way to achieving WHO goals
Despite the recent decline in treatment, Professor Dore said Australia is in a good position to meet the World Health Organization's elimination targets – to reduce deaths from hepatitis C by 65 percent and new infections by 80 percent by 2030.
"We are somewhat worried that things will decline in 2018 … but we are well on our way to treating 15,000 to 17,000 people this year," he said.
"There's no doubt the more people we treat, the faster the uptake is – especially in these high-risk populations – the faster we will reach those elimination goals."
In July, the federal government announced a $ 1 million to continue "education and awareness activities" to improve hepatitis C testing and therapy.