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. …
Templeton DJ1,2,3, Wong AK1, Balasubramanian S1, Fargie FM1. Department of Sexual Health Medicine, Sydney Local Health District, Sydney, Australia Kirby Institute, UNSW Sydney, Sydney, Australia Sydney Medical School, The University of Sydney, Sydney, Australia Last reviewed: October 2019 Introduction The epidemiology of sexually transmissible infections (STIs) among Australian people with HIV infection varies widely, in …
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Epidemiology Among MSM attending Australian sexual health clinics in 2017, chlamydia and gonorrhoea incidence was approximately 60% higher among HIV-positive MSM, compared with HIV-negative, MSM (3). In the previous five years, chlamydia incidence increased by 25% and 43% among HIV-positive and HIV-negative MSM, respectively. Over the same time period, gonorrhoea incidence also increased among HIV‑positive …
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Epidemiology Lymphogranuloma venereum is caused by Chlamydia trachomatis (CT) serovars L1-3 and continues to affect MSM worldwide (15). L2b is the serovar identified in the majority of LGV cases that have been diagnosed in Australia (16-21) and globally (22-24). Nationally, this infection is usually diagnosed in MSM, the vast majority of whom present with symptoms …
Epidemiology Mycoplasma genitalium (MG) is considered a new and emerging sexually transmitted pathogen (71), with an estimated global community prevalence of 1.3% (72). The prevalence of MG infection in HIV-positive individuals has not been systematically investigated in Australia, however a meta-analysis of observational studies worldwide suggested HIV-positive individuals bear a disproportionate burden of MG infection …
Epidemiology Trichomonas vaginalis (TV) causes the most common curable STI globally (77) and is highly prevalent among the Australian indigenous population (78). TV disproportionately affects older indigenous women living in remote settings (4, 78), but is rarely diagnosed in urban Australia (79-81). TV infection increases the risk of HIV acquisition by 50% (77) and has …
Epidemiology Syphilis is caused by the spirochete Treponema pallidum subspecies pallidum. This obligate human pathogen is primarily transmitted via sexual contact between mucosal surfaces. In addition, cases of mother-to-child transmission of syphilis are being reported in the current epidemic (86). In Australia, syphilis disproportionately affects indigenous Australians and MSM populations. Among HIV-positive MSM attending sexual …
Epidemiology Anogenital herpes is caused by herpes simplex virus (HSV) type 1 (HSV1) or type 2 (HSV2). Infections caused by this virus are common across the world but there are variations in prevalence between countries and population groups. HSV disease is not a notifiable disease in Australia so there are limited data regarding disease prevalence. …