It is estimated that about 13% of PLHIV have coinfection with Hepatitis C. In Queensland, this equates to about 360-450 people living with HIV/HCV coinfection. It is known that HIV speeds up hepatitis C disease progression and so worsens hepatitis C outcomes. Less is known of the effect of hepatitis C on HIV, although it may elevate HIV viral load.
Hepatitis C can be acquired sexually, and this is rising among gay men/men who have sex with men. Transmission can also occur through the sharing of injecting equipment among people who use drugs. More info? http://www.positivelife.org.au/images/PDF/Factsheets/Sex-Drugs-HepC.pdf
The good news is, if you haven’t heard already, that new direct acting antivirals (DAAs) may cure hepatitis C in as little as 8-12 weeks of treatment, comprising taking a single daily pill (or sometimes 2), with little or no side effects. There may be some HIV antiretroviral treatment interactions with some hepatitis C treatments, but this will be managed by your treating doctor, and is able to be worked around and not be a problem, especially for the short duration of taking hepatitis C treatments. Talk to your doctor about the new hepatitis C treatments. With treatment, there is a very real, high chance most people (95%) can cure their hepatitis C, relieving the burden of coinfection.
Depending upon genotype (strain) of Hep C, the following info-graphic shows which treatments will likely be chosen (and their brand names): http://www.ashm.org.au/resources/Pages/978-1-920773-46-5.aspx
Anyone with hepatitis C is eligible for the PBS listed (subsidised) treatment – which is $6.20 per month with a health care card or $38.10 for those without a health care card/non-concession rate. Medicare ineligible people with hep C may need to discuss access options with their doctor/specialist, or contact Hepatitis Queensland on 07 3846 0020, or 1800 437 222, or firstname.lastname@example.org or www.hepqld.asn.au
The Kirby Institute is conducting a research project in support of the uptake of these new treatments among people living with HIV and Hepatitis C. The CEASE project is an ongoing national surveillance and hep C treatment scale-up project for people living with HIV and hep C. It has 5 components, which includes a component (CEASE-V) for non-responders or relapsers (i.e. people who did not achieve sustained cure from previous hep C treatment) or people who were reinfected with hepatitis C (after previous successful treatment). Recruitment is currently open for the surveillance phase (surveying among PLHIV with hep C coinfection) and those who are about to commence the new hepatitis C treatments in association with their local treating physician.
All enquires for the CEASE project can be directed to the trial coordinator at The Kirby Institute: Miss Lanni Lin on: (02) 9385 9970; or at email@example.com
Clinical sites for the CEASE project in Queensland are: Brisbane Sexual Health Clinic, Cairns Sexual Health clinic, and Royal Brisbane Hospital (Infectious Diseases unit).
NAPWHA Media Release: http://napwha.org.au/time-talk-about-hivhcv
About the CEASE project: https://kirby.unsw.edu.au/project/cease
About Hep C coinfection and the new hepatitis C treatments: https://www.qpp.org.au/latest/the-end-to-hepatitis-c