Much more to learn about Hepatitis C virus
Since the identification of the hepatitis C virus (HCV) in 1989, hepatitis C has become a national epidemic, with an estimated 11,000 new infections occurring each year. Australian doctors have made progress in handling the disease, but there is still a long way to go, argues Professor Robert Batey in the latest issue of the Medical Journal of Australia.
Professor Batey, of the Division of Medicine at the John Hunter Hospital in Newcastle, says that more than 150,000 Australians are known to be infected.
Australia was the first country to develop a National Strategy for HCV. Some of the important steps taken to deal with the epidemic have included
- the release of two major reports (in 1994 and 1997) by the National Health and Medical Research Council, directing approaches to the diagnosis, treatment and management of HCV-infected people and, to a lesser extent, prevention of further spread;
- the staging by NSW Health of Hepatitis C Awareness Weeks in 2000 and 2002 to increase public awareness of the disease; and
- the release by NSW Health of a Treatment and Care Plan for HCV, which emphasises the importance of general practitioners in the evaluation and management of HCV-infected people.
However, a recent report by the Anti-Discrimination Board of NSW on hepatitis-C-related discrimination presents compelling evidence that there is still much more to be done if we as a society are to be seen to be dealing caringly and rationally with the disease.
Professor Batey claims that the rate of HCV infection is increasing, largely because more young people are choosing to commence injecting drug use. Many young people tend to ignore safe injecting practices in their early phase of drug use.
" a trend to downplay the need for treatment of all patients. ... Many major centres now offer support services and education programs, allowing individuals to defer treatment, awaiting better options in the future," Professor Batey says.
Progress is being made in providing better services for high-risk populations such as prison inmates, with the appointment of specialists to Corrections Health services.
HCV-infected people from non-English-speaking backgrounds have the added problem of a language barrier. Treatment facilities have become increasingly aware of the need to provide special support for these patients.
Professor Batey makes the following recommendations:
- Greater attention must be directed to reducing spread of the disease within the most-at-risk community, namely our population of injecting drug users.
- We need to increase public awareness of the improved efficacy of treatments.
- The HCV research effort requires further support from major funding bodies.
A greater understanding of the virus, the mechanisms of viral clearance and the immunopathogenesis of the disease is required urgently.
This knowledge would help us to develop a vaccine.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Professor Robert G Batey (02) 4921 3486 (B/H)
(0419) 481 546 (A/H)
Sarah Crichton (0419) 440 076
Public Affairs, AMA