Hepatitis C Drug Resistance

Direct-acting antiviral drugs (DAAs) to treat hepatitis C have proven to be a spectacular success, being able to cure more than 95% of people who have been living with the virus. However, a growing issue has implications for the design of future DAAs, and that is the ability of the hepatitis C virus–like all viruses–to mutate. Mutant versions of viruses can “learn” to defeat the medications used to treat them by changing their structure or the way they interact with the bodies they infect.

When they help the virus evade the effects of medication, we call these changes “drug resistance mutations” (DRMs), and they can make it much harder to cure infections. When a drug-resistant version of a virus becomes the dominant one, it can make a previously useful drug completely ineffective.

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DAA Treatment for Children

Chronic hepatitis C virus (HCV) infection affects around 3.5 million children worldwide, and in Australia, it’s estimated that it affects at least 4 children per million under 15 years old. Children with chronic hepatitis C infection can suffer from reduced quality of life, social stigmatisation, and inadequate access to specialist care. As with adults, the disease can progress to hepatic fibrosis, chronic liver disease, and hepatocellular cancer.

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Handy Tool Simplifies Management of Hepatitis C Treatment

One of the key planks of Australia’s hepatitis C elimination strategy is increasing treatment through management by General Practitioners (GPs), making it easier for individuals to receive treatment and facilitating access to hard-to-reach communities.

GP training programs have been rolled out across the country and GP prescribing had increased from 8 per cent in March to 31 per cent in December. However, most prescribing (62 per cent) are still by specialists and GP prescriptions in South Australia, Northern Territory, ACT and Victoria are significantly below average.

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New Improved Hepatitis B Medicine to be Considered for PBS

As Australians with hepatitis C are being cured at unprecedented rates, there is promise of a better medicine for those living with chronic hepatitis B who need treatment.

The Pharmaceutical Benefits Advisory Committee (PBAC) will, in March, consider for recommendation, a new medicine which promises the same efficacy as current drugs but with less toxic side effects.

The current medicine, tenofovir disoproxil fumarate (TDF), is effective in suppressing the hepatitis B virus but is also linked to bone density loss and renal dysfunction in some patients. This is due to the high level of tenofovir circulating in the body.

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Helping People Adhere to Treatment Helps Treatment Succeed

The development of direct-acting antiviral (DAA) treatments has revolutionised the treatment of hepatitis C in Australia. DAAs are effective and, when patients follow the medication regime, can cure more than 90% of those who take the treatment. But at the moment there are limited resources to inform and guide health professionals as they try to provide adherence support to those undergoing DAA treatment.

Medication adherence refers to the way an individual takes a medication, including the use of the correct medication, the correct dose and time, duration and timely refilling of repeat prescriptions.

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