Lives back on track

New breakthrough antiviral medicines for Hepatitis C that replace old interferon therapies offer a cure for most people and have few or no side-effects.

INDEPENDENT LIFESTYLE - Howard Jillings enjoys an active healthy lifestyle due to new treatment for Hep C, pictured Thursday January 31, 2019 - pic Mike Burton

New breakthrough antiviral medicines for Hepatitis C that replace old interferon therapies offer a cure for most people and have few or no side-effects.

Howard Jillings has got his life back. After more than 15 years of hell, all it took was two pills a day for three months. “I’d resigned myself to having a disease for life that would only get worse,” he says. “But now I’m active and healthy and couldn’t ask for more.” Jillings is a living example of a nationwide strategy that aims to eliminate hepatitis C as a public health concern.

With a cure rate greater than 95 per cent, the Federal Government funding of breakthrough antiviral medicine has brought relief to tens of thousands of Australians. The challenge now is to find the more than 180,000 remaining, who live with the virus. A partnership program between Hepatitis Australia and Hepatitis SA is targeting men aged 45 years and over. Research has shown this age group to have among the highest prevalence of hepatitis C.

In contrast to the old interferon therapies, the new hepatitis C cures consist of daily tablets taken for around eight to 12 weeks, with few if any side-effects. Listed on the Federal Government’s Pharmaceutical Benefits Scheme, these new drugs can be prescribed by GPs, avoiding long waits at liver clinics, and reducing the time and cost for people with hepatitis C.

Dr Samuel Elliott estimates around 10,000 South Australians are eligible for the new treatments but haven’t come forward. With 20 years experience in the field of blood-borne viruses, along with Masters degrees in public health and tropical medicine, Dr Elliott has a thorough understanding of the difficulties in dealing with hepatitis C. He says people with hepatitis C face the challenges of unnecessary stigma, while many GPs need to order a screening test as part of their approach to liver issues.

“People can acquire hepatitis C through a variety of ways, not just through sharing needles in drug use,” Dr Elliott says, referring to the stigma. “Meanwhile, the message needs to get through to some GPs that a patient presenting with a raised liver function has a moderate possibility of having hepatitis C. A simple, specific screening test can confirm or deny this.”

The problem with hepatitis C is that it can remain unnoticed for many years, with the only symptom being general tiredness. “It remains ‘silent’ until pain in the upper-abdomen reveals the extent of hepatitis C damage to the liver,” Dr Elliott says.

Howard Jillings is a classic case of how hepatitis C can remain undetected. “I found out I had it by sheer accident when I tried to donate blood to the Red Cross in the 1990s,” he says. Although having no obvious physical symptoms, Jillings was assessed as qualifying for interferon treatment. A program similar to cancer chemotherapy, it had devastating side-effects.

“The first lot I tried was in 2003 and it consisted of injecting myself in the stomach with interferon each day and taking two tablets twice a day,” he says. “It failed completely and gave me great grief but I just got on with things in my working life.” He tried another treatment, with similar side-effects. “I lost weight, was chronically tired and emotionally it was a huge strain on me,” he says. “It became a pervasive illness.”

In 2016, now aged in his 60s, Jillings was prescribed the new anti-viral medication. “Within three months I was cured,” he says. “I have yearly tests that show my liver has regenerated and is getting healthier and healthier. I encourage everyone, especially people in my age group, to come forward and get tested for hepatitis C if they have any concerns."

Dr Elliott says hepatitis C can be eliminated from South Australia within eight years. “It is an exciting time to be a doctor and a privilege to be able to treat hepatitis C with the range of drugs available now on the Pharmaceutical Benefits Scheme.”

Howard Jillings sums up the situation in six words: “My liver will see me out.”

Forget the stigma

 “The medical approach to hepatitis C is that it’s not about the past, it’s about fixing the future,” says Dr Elliott of the stigma surrounding hepatitis C. The public perception is skewed by publicity surrounding chronic drug users and programs aimed at treating the prison population. The reality is that hepatitis C was only discovered in 1989, and tests for its presence in blood were only available from 1990.  This means people who had blood transfusions and surgery before this may be at risk.

Other transmission routes include experimental drug use and some tattooing practices dating back decades. Even some health care and emergency services workers may have been at risk.One area not often mentioned is the possibility of some Australians born overseas in parts of Europe and South-East Asia having hepatitis C due to unsterile medical procedures. Left untreated, hepatitis C can destroy the liver with cirrhosis, cancer or total liver failure. However, if diagnosed and treated early, even a damaged liver has a remarkable ability to repair and regenerate itself if treated correctly.

SA in the spotlight

A joint campaign between Hepatitis Australia and Hepatitis SA is targeting men aged 45 years and over. It wants them to come forward for screening for hepatitis C and also take advantage, if necessary, of the Pharmaceutical Benefits Scheme’s inclusion of new anti-viral medicines. These have been available since 2016 and the aim is to have Australia free of hepatitis C by 2030.

“Australia is a leader in the global response to hepatitis C,” says Hepatitis Australia’s spokesperson Helen Tyrrell. “But a concerted effort is needed to break down the barriers to more Australians speaking to their GPs about hepatitis C treatment.” While 2016 was seen as the watershed year for hepatitis C in Australia, last year the number of Australians coming forward for the antiviral therapy sharply declined. It is estimated that 182,000 Australians are still living with the virus. 

Last year Hepatitis Australia launched the Test, Cure, Live campaign to prompt people to get tested if they think they might be at risk, and for people with hepatitis C to seek treatment. The campaign includes a podcast series #MakingHepatitisCHistory, which features people sharing their stories of being cured of hepatitis C. 

For more information call 1800 437 222 or visit testcurelive.com.au

Originally published as Lives back on track