Patients with hepatitis C might be hesitant to seek life-saving treatment due to generalized feelings of mistrust toward the health system, and ongoing stigma from health workers toward injectable drug users, according to new research from the University of New South Wales’ (UNSW) Centre for Social Research in Health in Australia.
The report, “Annual Report of Trends in Behaviour Supplement 2016 on viral hepatitis,” was recently released at the 10th Australasian Viral Hepatitis 2016 Conference.
An estimated 227,306 people had chronic hepatitis C infection in Australia in 2015, the report revealed, but only 22% of these patients had been treated for the disease.
Australia is, however, on track to provide treatment to more hepatitis C patients in 2016 alone than in the past two decades, largely because of the Australian Pharmaceutical Benefits Scheme (PBS) listing of new, oral curative antiviral treatments for hepatitis C, which was launched in March 2016.
“Australia is witnessing the most rapid uptake of new treatments seen anywhere in the world, thanks to the unique approach we have taken in making the medicines available without restriction,” said Professor Gregory Dore with the Kirby Institute in a press release.
“To capitalize on the opportunities provided by these new treatments, we need to keep working to make sure we understand who isn’t coming forward for treatment and why, and how we can deliver services that best address these barriers,” said Carla Treloar, a UNSW professor and director of the Centre for Social Research, on a different UNSW release.
In order to determine which barriers prevented patients to access or seek treatment, several surveys were analyzed in the report.
One survey, involving 416 Australians who had acquired hepatitis C through the use of non-sterile injecting equipment, found that feelings of discrimination by health workers lessened their probability of engaging in treatments.
Another, a study in 86 HIV-positive men, 34 HIV-negative men, and 101 men who had not been tested for HIV, found that HIV status influenced a person’s knowledge and attitudes toward people who inject drugs and hepatitis C patients. These results suggested that a ‘one size fits all’ approach to hepatitis C education and prevention among homosexual men did not work, and a more personalized approach was needed.
Still another survey, involving 405 people in the LGBT community, showed that this community is generally unaware of the new testing and treatment options for hepatitis C, with only 35% reporting being informed about a treatment that could cure the disease.
Interestingly, a survey of 203 Aboriginal hepatitis C patients found that those who felt closer to their Aboriginal community were likely to be more resilient, experience less hepatitis C-associated stigma, and have a better quality of life in comparison to those who were not as attached.
In addition, the numbers of hepatitis B also remain a health concern. The Kirby Institute released the “Hepatitis B and C in Australia Annual Surveillance Report Supplement 2016,” revealing that approximately 232,600 people had chronic hepatitis B infection in 2015, and of these, only 62% were diagnosed, and only 6% had received treatment.
“Effective treatments for hepatitis B have been available in Australia for a long time, but we need to scale up diagnosis and treatment of people with chronic hepatitis B infection in order to achieve the national targets of 80% diagnosed and 15% on treatment,” said Dore.
“Analysis of the evidence regarding best practice in hepatitis B from around the world suggests that management in Australia’s general practice setting can be improved through greater community-based outreach programs and education programs for health professionals,” Treloar said. “Stigma should also be recognized as a factor influencing decisions about care and treatment for people living with hepatitis B.”