HCV elimination: is the bulk of the iceberg being missed?

In 2016, the Australian government spent more than 1 billion dollars to make hepatitis C virus (HCV) direct-acting antivirals (DAAs) available to all as part of a promising plan to eradicate HCV within a generation [1]. Moreover, Australia's unique approach of offering well-tolerated pan-genotypic DAAs (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) through general practitioners has significantly increased treatment accessibility. As a result, ∼60% of Australians who are living with hepatitis C have received treatment. While significant progress has been made, reaching the 2030 elimination goal poses a challenge that is both feasible and attainable [2–4]. Current testing strategies are not comprehensive enough to fully identify all HCV-infected people. Current screening in Australia targets high-risk populations, including people who inject drugs, those of indigenous descent, those who take part in high-risk sexual behavior, or those with current or a history of incarceration. Such targeted screening strategies continue to enforce stigma and allow discrimination to linger in community and healthcare settings. Indeed, >70% of people living with HCV in Australia have reported experiencing stigma and discrimination, including withholding treatment, diagnostic overshadowing, unwelcoming, and/or excessive infection control behaviors [5]. In fact, current screening is not comprehensive enough to fully identify all HCV-infected people. The aim of this study is to assess HCV prevalence within non-risk-factor populations in our community who are attending Blacktown and Mt Druitt hospitals’ outpatient services in Western Sydney, New South Wales, Australia.

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Gastroenterology report

12

2052-0034

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