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Eliminating hepatitis C in Australia needs informed patients and enabled GPs

Paul J Clark
Med J Aust 2021; 215 (7): . || doi: 10.5694/mja2.51264
Published online: 4 October 2021

A national education program would facilitate achieving the full potential of highly effective curative therapies

Less than a decade ago, formidable obstacles challenged Australians hoping to be cured of chronic hepatitis C virus (HCV) infections. Treatment was publicly funded only after liver damage had been detected by liver biopsy. For most people, it consisted of a year‐long, arduous course of weekly injections with pegylated interferon, which frequently caused bone pain and cytopenia, thyroid disease, and, consequently, depression. Dozens of daily supplementary tablets elicited further side effects, including haemolytic anaemia and rash. The risk of death from decompensated liver disease precluded any treatment for many with cirrhosis. Despite the toxicity and difficulty of HCV treatment, the chance of cure (that is, sustained viral response) was only 50% for most patients.1


  • 1 The University of Queensland, Brisbane, QLD
  • 2 Princess Alexandra Hospital, Brisbane, QLD
  • 3 Mater Hospital, Brisbane, QLD


Correspondence: paul.j.clark@uq.edu.au

Competing interests:

I have received funding from the Australian Department of Health and the National Health and Medical Research Council. Over the past ten years I have received unrestricted research funding, education grants, and honoraria either directly or indirectly from Gilead, Bayer, Abbvie, and Johnson and Johnson.

  • 1. Fried MW. Side effects of therapy of hepatitis C and their management. Hepatology 2002; 36 (5 Suppl 1): S237–S244.
  • 2. Dowsett LE, Coward S, Lorenzetti DL, et al. Living with hepatitis C virus: a systematic review and narrative synthesis of qualitative literature. Can J Gastroenterol Hepatol 2017; 2017: 3268650.
  • 3. Bukh J. The history of hepatitis C virus (HCV): basic research reveals unique features in phylogeny, evolution and the viral life cycle with new perspectives for epidemic control. J Hepatol 2016; 65 (1 Suppl): S2–S21.
  • 4. Stafford F, Dore GJ, Clackett S, et al. Prescribing of direct‐acting antiviral therapy by general practitioners for people with hepatitis C in an unrestricted treatment program. Med J Aust 2021; 215: 332–333.
  • 5. The Kirby Institute for infection and immunity in society. National update on HIV, viral hepatitis and sexually transmissible infections in Australia: 2009–2018. Sydney: Kirby Institute (UNSW Sydney), 2020. https://kirby.unsw.edu.au/report/national‐update‐hiv‐viral‐hepatitis‐and‐sexually‐transmissible‐infections‐australia‐2009‐2018 (viewed Aug 2021).
  • 6. Hajarizadeh B, Grebely J, Martinello M, et al. Hepatitis C treatment as prevention: evidence, feasibility, and challenges. Lancet Gastroenterol Hepatol 2016; 1: 317–327.
  • 7. Clark PJ, Muir AJ. Overcoming barriers to care for hepatitis C. N Engl J Med 2012; 366: 2436–2438.

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