David Iser Gastroenterologist, St Vincent’s Hospital, Melbourne Andrew Chan Hepatology Fellow, Austin Health Chronic Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and an important public health concern in Australia. Around 25% of acute HCV infections will clear spontaneously within 6 months; however, the remaining 75% will progress to chronic …
All people with HIV should be screened for HCV, and all people found to have concurrent HCV should be prioritised for treatment of HCV and be managed by a multidisciplinary team with experience in managing both conditions. HIV-HCV is associated with a reduced HCV clearance rate8 and a higher rate of cirrhosis compared with people …
Screening for HCV should be performed in people who have associated identifiable risk factors. Those with HCV are often asymptomatic, unless they have developed advanced liver disease. A major barrier to HCV elimination is that a substantial proportion of those who have acquired HCV are unaware of their status and not adequately screened and therefore, …
Adequate assessment of liver disease severity should be performed in all people with HCV before prescribing DAA treatment. The patient’s cirrhosis status is a requirement when seeking PBS authority, and adequate assessment of liver disease severity helps determine clinical decisions surrounding: treatment priority; factors that may adversely affect treatment efficacy, and therefore the choice of …
The primary goal of therapy is to cure HCV, defined by achieving SVR. There are multiple clinical benefits in achieving SVR including: preventing further transmission of HCV; preventing complications of HCV-related liver disease, such as hepatic inflammation, fibrosis, cirrhosis, and HCC, and extrahepatic diseases; it reduces all-cause mortality; improves individual quality of life and removes …
Grebel J, Raffa JD, Lai C, et al. Factors associated with spontaneous clearance of hepatitis C virus among illicit drug users. Can J Gastroenterol 2007;21:447–51. Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet 1997;349:825-32. World Health Organisation. …
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