Australia needs to increase testing to achieve hepatitis C elimination

• DOI: 10.5694/mja2.50544
• Publication Date: 2020-03-13T15:18:46Z
• Authors: Nick Scott; Rachel Sacks‐Davis; Amanda J Wade; Mark Stoove; Alisa Pedrana; Joseph S Doyle; Alexander J Thompson; David P Wilson; Margaret E Hellard
• Keywords: Hepatitis C

Objectives To assess progress in Australia toward the 2030 WHO hepatitis C elimination targets two years after introduction of highly effective direct-acting antiviral (DAA) treatments. Design Analysis quarterly data on government-subsidised RNA testing and treatment Australia, January 2013 – June 2018. Changes levels associated with DAA availability were assessed an autoregressive integrated moving average (ARIMA) statistical model, impact by different estimated using a mathematical model. Major outcome measures Hepatitis prevalence among people who inject drugs; annual incidence relative to 2015 levels; projections for care cascade 2030. Results The mean number treatments initiated increased from 6747 during 2013–2015 (before DAAs) 28 022 2016–18; diagnostic tests 17 385 23 819. If current trends continue (ie, 2018 numbers are maintained but decline 50%), it is projected that only 72% infected would be treated (by 2025 all diagnosed treated). 59% lower than 2015, well short target 80% reduction. identification exposed must at least 50% reach targets. Conclusion programs should focus increasing rates linkage maintain adequate treatment.