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Australian recommendations for the management of hepatitis C virus infection: a consensus statement

Alexander JV Thompson
Med J Aust 2016; 204 (7): 268-272. || doi: 10.5694/mja16.00106

Summary

  • Chronic hepatitis C virus (HCV) infection affects 230 000 Australians, who are at risk of progressive liver fibrosis leading to cirrhosis, liver failure and hepatocellular carcinoma.
  • HCV infection is curable, and all Australians living with HCV should be considered for antiviral therapy.
  • Interferon-free regimens involving combinations of sofosbuvir, ledipasvir, daclatasvir and/or ribavirin for 8, 12 or 24 weeks are now listed on the Pharmaceutical Benefits Scheme (PBS) for treating people with genotypes 1–3 HCV. Treatment for genotypes 4–6 HCV involves sofosbuvir plus peginterferon-alfa and ribavirin for 12 weeks.
  • The PBS listing allows these therapies to be prescribed by specialists experienced in treating chronic HCV infection or by general practitioners in consultation with one of these specialists.
  • People with cirrhosis and other special populations (eg, those with decompensated liver disease or renal impairment) should be referred for specialist care.
  • Key issues during pre-treatment assessment include identifying HCV genotype, evaluating for cirrhosis and considering concomitant medications for risk of drug–drug interactions.

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  • Alexander JV Thompson

  • Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC


Acknowledgements: 

The consensus statement was prepared by an expert panel representing the Gastroenterological Society of Australia (Australian Liver Association), the Australasian Society for Infectious Diseases, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, the Australasian Hepatology Association, Hepatitis Australia and the Royal Australian College of General Practitioners. Alexander J Thompson (chair), Fran Bramwell, Wendy Cheng, Krispin Hajkowicz, William Kemp, Gail Matthews, Lucy McDonald, Stuart Roberts, William Sievert, Alison Stewart, Simone Strasser, Caroline Tallis, Helen Tyrrell, Alan Wigg. Peter Angus, Narin Bak, David Baker, Annie Balcombe, Sally Bell, Wendy Cheng, Paul Clark, Mark Danta, Josh Davis, Anouk Dev, Greg Dore, Mark Douglas, Joe Doyle, Geoff Farrell, Jacob George, Paul Gow, Winita Hardikar, Margaret Hellard, Jessica Howell, David Iser, Miriam Levy, Andrew Lloyd, John Lubel, Graeme Macdonald, Gerry MacQuillan, Kevin Marriott, Susan Mason, Geoff McCaughan, Stephen Pianko, David Pieper, Elizabeth Powell, Joe Sasadeusz, David Siebert, Kasha Singh, Steven Tong, Deborah Warneke-Arnold, Martin Weltman, Amany Zekry.

Competing interests:

Alexander Thompson is the recipient of a National Health and Medical Research Council (NHMRC) Research Fellowship and receives funding from the NHMRC; he has received research grants from Gilead Sciences, BMS, AbbVie, Spring Bank Pharmaceuticals, MSD and Arrowhead; he has consulted for Gilead Sciences, BMS, AbbVie, Roche Diagnostics, MSD and Spring Bank Pharmaceuticals; and he has presented sponsored lectures for Gilead Sciences, BMS, AbbVie, MSD, Roche Diagnostics and UCB.

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