WA News Letters WA Slow Hep C Uptake
WA Slow Hep C Uptake
Written by Dr Donna Mak
Tuesday, 29 November 2016

Dear Editor,

GPs can now initiate new hepatitis C treatments without specialist authorisation. WA Health urges doctors to inform their patients about the effectiveness (>90% cure rate with a 12- 24 week treatment course) of direct acting antiviral hepatitis C treatments and the fact that these oral treatments have very few side-effects.

From October 1, 2016, GPs have been able to initiate PBS-funded S85 hepatitis C treatments without specialist authorisation. Patients must be treated by a medical practitioner experienced in the treatment of chronic hepatitis C infection; or in consultation with a gastroenterologist, hepatologist or infectious diseases physician experienced in the treatment of chronic hepatitis C infection.

The PBS application must include:

  •                      The hepatitis C virus genotype; and
  •                      The patient’s cirrhotic status (non-cirrhotic or cirrhotic).

It is necessary to record in the patient’s medical records:

  •                      Evidence of chronic hepatitis C infection (repeatedly antibody to hepatitis C virus (anti-HCV) positive and hepatitis C virus ribonucleic acid (HCV RNA) positive); and
  •                      The hepatitis C virus genotype.

Based on PBS data collected from March to July 2016, WA is lagging behind in terms of treatment uptake, with only 7% of patients with chronic hepatitis C having been started on treatment, in contrast with 19% in the ACT and 11-13% in NSW, Qld, SA and Victoria.

The Silver Book (Guidelines for managing STI and BBVs ww2.health.wa.gov.au/Silver-book) now includes a revised chapter on hepatitis C including a referral form.

Online training resources in the new hepatitis C treatments can be accessed at the following websites:

https://lms.ashm.org.au/

http://www.nps.org.au/health-professionals/cpd/activities/online-courses/managing-hepatitis-c-in-primary-care

http://hepatitis.ecu.edu.au/

The Australasian Society of HIV, Hepatitis and Sexual Health Medicine (ASHM) will provide free face-to-face training in WA and webinars in 2017. For more information email Sonja Hill at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Prof Donna Mak, Communicable Disease Control Directorate, WA Health

ED: An update from an ongoing study by St George Hospital in Sydney has found that the majority of 114 hepatitis C patients who were put on direct-acting antivirals after PBS listing in March were being treated at a liver clinic. Only six were treated by GPs and a further 25 by specialists in private rooms. In a survey of 131 GPs about DAA therapy, other researchers from the hospital have found 29% feel they are up to date with Australian guidelines for managing non-cirrhotic patients. Just six of the GPs had prescribed DAAs and a further 37 planned to. The barriers reported by the non-prescribers were unfamiliarity with the drugs (88%), uncertainty about the need for the treatment (45%) and uncertainty about whether pharmacies dispensed the drugs (28%).Only 51% of GPs were aware that cure rates with the new regimens were over 90%, and 21% were not aware that DAAs are oral medications.