Scale‐up of hepatitis C treatment in prisons is key to national elimination

Timothy Papaluca, Margaret E Hellard, Alexander J V Thompson and Andrew R Lloyd
Med J Aust 2019; 210 (9): . || doi: 10.5694/mja2.50140
Published online: 20 May 2019

Prison‐based antiviral treatment for chronic hepatitis C is a critical element of the national elimination goal

In 2016, it was estimated 227 000 Australians had chronic hepatitis C virus (HCV) infection, with the majority infected through unsafe injecting drug use.1 The advent of direct‐acting antiviral (DAA) therapies for HCV infection, and their subsequent listing on the Pharmaceutical Benefits Scheme in March 2016, means that all Australians with chronic HCV, including prisoners, can access well tolerated, short course, highly curative treatments, regardless of how they acquire their infection or their disease stage. This universal access approach is supported by modelling that shows that increasing treatment uptake among people who inject drugs is an effective public health measure to reduce community prevalence due to the interruption of HCV transmissions.2 These elements underpin Australia's efforts to meet the World Health Organization goal to eliminate HCV as a public health threat by 2030, including key targets of a 90% decline in new infections, a reduction in HCV‐related mortality by 65%, and HCV treatment provision for 80% of those infected.3

  • Timothy Papaluca1
  • Margaret E Hellard2
  • Alexander J V Thompson1
  • Andrew R Lloyd3

  • 1 St Vincent's Hospital, Melbourne, VIC
  • 2 Centre for Population Health, Burnet Institute, Melbourne, VIC
  • 3 Kirby Institute, UNSW, Sydney, NSW



The manuscript of this article was prepared on behalf of the National Prisons Hepatitis Network and has been approved by the Network members. Margaret Hellard and Alexander Thompson are supported by National Health and Medical Research Council (NHMRC) Research Fellowships. Andrew Lloyd is supported by an NHMRC Practitioner Fellowship.

Competing interests:

Timothy Papaluca has received speaker fees from MSD. Margaret Hellard has received investigator‐initiated support for hepatitis‐related research from Gilead Sciences, AbbVie and GSK. Alexander Thompson has received investigator‐initiated support for hepatitis‐related research from Gilead Sciences, AbbVie and Merck. He is a member of advisory boards for Gilead Sciences, AbbVie, MSD, Bristol‐Myers Squibb and Eisai, and has received speaker fees from Gilead Sciences, AbbVie, MSD and Bristol‐Myers Squibb. Andrew Lloyd has received investigator‐initiated support for prisons hepatitis‐related research from Gilead Sciences and MSD.


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