Eradicating Hepatitis C in South Auckland – the first 12 months
McGouran D, Counties Manukau District Health Board
Stone J, Mills L, Gerred S
Introduction: Approximately 5400 people in the Counties Manukau Health (CMH) catchment area are infected with Hepatitis C virus (HCV). Most are unaware of their infection. It is estimated that to eradicate HCV from New Zealand we need to cure 10% of those infected each year. Restricted access to Direct Acting Anti-viral therapy (DAA therapy) has been funded in New Zealand since the 1st July 2016. Clinical trials indicate cure rates above 95%. Patients are also treated in clinical trials, compassionate supply programs, and some self-fund therapy obtained overseas.
We have documented the number of patients treated and cured of HCV in the CMH region in the last 12 months.
Methods: Patients treated between 1st July 2016 and 1st July 2017 were identified and their electronic records reviewed. Ethical approval was gained.
Results: Viekira Pak +/- ribavirin therapy was commenced in 102 patients, 79 have completed their post treatment bloods. Mean age of 56 years, 63% male, 23% cirrhotic, 22% treatment experienced, and 58% Genotype 1a. Overall cure rates were 91% (72/79), genotype 1a (96%) and 1b (85%), P = 0.1. Of the 7 patients not cured, 4 withdrew from therapy due to adverse events. An additional 13 patients received DAA therapy (11 purchased and 2 received funded Harvoni therapy).
Conclusions: In the last year, 115 patients have received DAA therapy, roughly three times the number treated in previous years but well short of the target of treating 10% of those infected annually. Cure rates appear acceptable. Funding of DAA therapy for all those infected with HCV will substantially increase the numbers treated each year but the main barrier to achieving HCV eradication in South Auckland is the large percentage of unidentified infections.