Queensland HealthQH 845 1611

HEPATITIS

HEPATITIS CACTION PLAN 2016–2021

QUEENSLAND

Queensland Hepatitis C Action Plan 2016–2021Published by the State of Queensland (Queensland Health), November 2016

This document is licensed under a Creative Commons Attribution 3.0 Australia licence.

© State of Queensland (Queensland Health) 2016

You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Queensland Health).

For more information contact:Strategic Policy Unit, Department of Health, GPO Box 48, Brisbane QLD 4001

strategicpolicy@health.qld.gov.au

Disclaimer:

The content presented in this publication is distributed by the Queensland Government as an information source only. The State of Queensland makes no statements, representations or warranties about the accuracy, completeness or reliability of any information contained in this publication. The State of Queensland disclaims all responsibility and all liability (including without limitation for liability in negligence) for all expenses, losses, damages and costs you might incur as a result of the information being inaccurate or incomplete in any way, and for any reason reliance was placed on such information.

With the availability of direct acting anti-viral medications that can cure 95 per cent of people with chronic hepatitis C, the Queensland Government is committed to increasing access to hepatitis C treatment and reducing hepatitis C transmission in Queensland.

This action plan acknowledges the current provision of quality hepatitis C prevention, testing and treatment services within Queensland Health, the private sector and community based organisations across Queensland.

The plan complements this ongoing work and will drive a reduction in new hepatitis C infections and increase treatment uptake in Queensland through:

• targeted best practice prevention activities

• increased access to testing for hepatitis C

• increased access to treatment for people diagnosed with chronic hepatitis C.

The success of these efforts depends not on reaching all people but on reaching the right people through effective targeted interventions.

The action plan aligns with the Queensland Sexual Health Strategy 2016–2021, the Queensland Hepatitis B Action Plan 2016–2021 and the Queensland HIV Action Plan 2016–2021 to ensure a comprehensive approach to blood-borne virus prevention and treatment in Queensland. It also aligns with and supports the Fourth National Hepatitis C Strategy 2014–2017 and the Fourth National Aboriginal and Torres Strait Islander Blood-Borne Viruses and Sexually Transmissible Infections Strategy 2014–2017.

The Hon Cameron Dick MP

Minister for Health and Minister for Ambulance Services

Foreword

Hepatitis C causes inflammation of the liver. Chronic infection can result in progressive liver inflammation leading to cirrhosis (scarring of the liver) and cancer.

Hepatitis C virus (HCV) remains the most frequently reported blood borne virus infection in Queensland with 2581 cases notified in 2015.

HCV cases reported in QLD 2015

2581

New treatments listed on the Pharmaceutical Benefits Scheme (PBS) from 1 March 2016 have a cure rate of 95 per cent and are available to everyone over the age of 18 years infected with chronic hepatitis C.

Cure rate for new treatments listed on PBS

95%

New treatments can be prescribed by medical practitioners including general practitioners, who are experienced in the treatment of chronic hepatitis C infection; or in consultation with a gastroenterologist, hepatologist or infectious diseases physician experienced in the treatment of chronic hepatitis C infection.

Hepatitis C at a glance

Out

com

e1.

Impl

emen

t a c

ompr

ehen

sive

ap

proa

ch to

redu

ce h

epat

itis

C

tran

smis

sion

2. In

crea

se v

olun

tary

test

ing

fo

r hep

atiti

s C

3. In

crea

se tr

eatm

ent u

ptak

e by

pe

ople

with

chr

onic

hep

atiti

s C

4.

Incr

ease

aw

aren

ess

of

hepa

titis

C tr

ansm

issi

on,

and

redu

ce s

tigm

a an

d di

scrim

inat

ion

rela

ted

to

hepa

titis

C

Targ

et

popu

latio

nsPe

ople

who

inje

ct d

rugs

, Abo

rigi

nal a

nd

Torr

es S

trai

t Isl

ande

r peo

ple,

cul

tura

lly a

nd

lingu

isti

cally

div

erse

peo

ple,

men

who

hav

e se

x w

ith

men

, peo

ple

in c

usto

dial

set

ting

s an

d yo

ung

peop

le.

Peop

le w

ho in

ject

dru

gs, A

bori

gina

l and

To

rres

Str

ait I

slan

der p

eopl

e, c

ultu

rally

an

d lin

guis

tica

lly d

iver

se p

eopl

e, p

eopl

e in

cu

stod

ial s

etti

ngs,

men

who

hav

e se

x w

ith

men

and

you

ng p

eopl

e.

All p

eopl

e liv

ing

wit

h he

pati

tis C

(inc

ludi

ng

thos

e in

cus

todi

al s

etti

ngs)

, clin

icia

ns

enga

ged

in v

iral

hep

atit

is tr

eatm

ent,

gen

eral

pr

acti

tion

ers

(GPs

), Al

coho

l and

Oth

er

Dru

gs (A

OD

) spe

cial

ists

and

oth

er s

peci

alis

t m

edic

al p

ract

itio

ners

.

Peop

le w

ho in

ject

dru

gs, A

bori

gina

l and

To

rres

Str

ait I

slan

der p

eopl

e, p

eopl

e fr

om c

ultu

rally

and

ling

uist

ical

ly d

iver

se

back

grou

nds,

men

who

hav

e se

x w

ith

men

, pe

ople

in c

usto

dial

set

ting

s an

d G

Ps.

Key

sett

ings

Prim

ary

Hea

lthc

are,

Hos

pita

l and

Hea

lth

Serv

ices

(HHS

s), N

eedl

e an

d Sy

ring

e Pr

ogra

ms

(NSP

s), c

usto

dial

an

d co

mm

unit

y se

ttin

gs

Prim

ary

Hea

lthc

are,

HHS

s, N

SPs,

cu

stod

ial a

nd c

omm

unit

y se

ttin

gsPr

imar

y H

ealt

hcar

e, H

HSs,

NSP

s,

cust

odia

l and

com

mun

ity

sett

ings

NSP

s, c

usto

dial

and

com

mun

ity

sett

ings

Incr

ease

the

prop

ortio

n of

Que

ensl

ande

rs d

iagn

osed

with

chr

onic

hep

atiti

s C

w

ho h

ave

unde

rgon

e tr

eatm

ent t

o 50

per

cen

t by

2021

.GO

AL

HEPA

TITI

S Q

UEE

NSL

AND

ACTI

ON

PLA

N 2

016–

2021

C

Out

com

e1.

Impl

emen

t a c

ompr

ehen

sive

ap

proa

ch to

redu

ce h

epat

itis

C

tran

smis

sion

2. In

crea

se v

olun

tary

test

ing

fo

r hep

atiti

s C

3. In

crea

se tr

eatm

ent u

ptak

e by

pe

ople

with

chr

onic

hep

atiti

s C

4.

Incr

ease

aw

aren

ess

of

hepa

titis

C tr

ansm

issi

on,

and

redu

ce s

tigm

a an

d di

scrim

inat

ion

rela

ted

to

hepa

titis

C

Prio

rity

actio

ns1.

1 En

sure

hep

atiti

s C

prev

entio

n pr

ogra

ms

targ

et p

rior

ity

popu

latio

ns.

1.2

Prom

ote

and

prov

ide

impr

oved

acc

ess

to a

full

rang

e of

ste

rile

inje

ctin

g eq

uipm

ent i

n th

e co

mm

unit

y.

1.3

Supp

ort i

mpr

oved

acc

ess

to O

pioi

d Su

bstit

utio

n Tr

eatm

ent (

OST

) for

pe

ople

who

inje

ct d

rugs

and

are

opi

oid

depe

nden

t, b

oth

in c

omm

unit

y an

d cu

stod

ial s

ettin

gs.

1.4

Prom

ote

and

supp

ort h

arm

redu

ctio

n st

rate

gies

in c

usto

dial

set

tings

.

1.5

Enga

ge w

ith C

omm

unit

y B

ased

O

rgan

isat

ions

(CBO

s) to

incr

ease

co

nsum

er h

epat

itis

C aw

aren

ess,

kn

owle

dge

and

prev

entio

n sk

ills

thro

ugh

peer

edu

catio

n an

d br

ief i

nter

vent

ions

.

1.6

Wor

k w

ith

PHN

s, H

HSs

and

CB

Os

to

pro

mot

e he

pati

tis C

trea

tmen

t as

pre

vent

ion.

1.7

Cont

inue

to c

olle

ct a

nd re

port

on

the

Que

ensl

and

Nee

dle

and

Syri

nge

Prog

ram

Min

imum

Dat

a Se

t and

co

ntin

ue to

par

ticip

ate

in th

e Au

stra

lian

Nee

dle

and

Syri

nge

Prog

ram

Sur

vey.

2.1.

Wor

k w

ith

PHN

s, C

BO

s an

d H

HSs

to

prom

ote

and

incr

ease

acc

ess

to te

stin

g an

d ea

rly

diag

nosi

s of

hep

atit

is C

.

2.2.

Exp

lore

cha

nges

in n

otifi

catio

n cr

iteria

for

prim

ary

hepa

titis

C d

iagn

osis

, foc

usin

g on

the

pres

ence

of c

ircul

atin

g vi

rus

rath

er

than

prio

r exp

osur

e to

the

viru

s.

2.3.

Wor

k w

ith

the

publ

ic la

bora

tory

sec

tor

to m

easu

re th

e ex

tent

of t

esti

ng b

ased

on

the

pres

ence

of c

ircu

lati

ng v

irus

un

dert

aken

follo

win

g he

pati

tis C

an

tibo

dy te

stin

g.

2.4.

Add

ress

bar

rier

s to

test

ing

thro

ugh

targ

eted

mar

keti

ng a

ctiv

itie

s, in

clud

ing

dire

ctio

n to

ser

vice

s, re

duci

ng

stig

ma

in th

e w

ider

com

mun

ity,

an

d cl

inic

ian

enga

gem

ent.

2.5.

Ens

ure

AOD

serv

ices

con

tinue

to p

rom

ote

the

prov

isio

n of

hep

atiti

s C

test

ing.

2.6.

Exa

min

e ho

w h

epat

itis

C n

otifi

cati

on

data

and

pro

cess

es c

an b

e im

prov

ed.

3.1.

Pr

omot

e en

hanc

ed a

cces

s to

hep

atit

is

C as

sess

men

t and

trea

tmen

t, a

nd

supp

ort c

omm

unit

y ba

sed

hepa

titis

C

trea

tmen

t.

3.2.

Co

ntin

ue to

sup

port

fund

ed s

ervi

ce

prov

ider

s to

impr

ove

hepa

titis

C

trea

tmen

t upt

ake

and

adhe

renc

e.

3.3.

Ex

amin

e an

d im

prov

e m

odel

s of

tr

eatm

ent a

nd c

are

to s

uppo

rt

the

trea

tmen

t of h

epat

itis

C in

the

com

mun

ity

by c

onti

nuin

g ex

isti

ng

spec

ialis

t hep

atit

is C

cap

acit

y th

roug

h liv

er a

nd in

fect

ious

dis

ease

s cl

inic

s,

whi

le re

view

ing

cons

ulta

tion

and

in

tegr

ated

pat

hway

s be

twee

n G

P an

d te

rtia

ry c

entr

es.

3.4.

H

HS,

PH

Ns

and

the

CBO

sec

tor t

o w

ork

colla

bora

tive

ly to

opt

imis

e he

pati

tis C

tr

eatm

ent u

ptak

e.

3.5.

Pr

omot

e en

hanc

ed a

cces

s to

hep

atit

is

C tr

eatm

ent i

n AO

D s

ervi

ces

and

cust

odia

l set

ting

s.

4.1.

Co

ntin

ue to

fund

and

sup

port

the

deve

lopm

ent a

nd d

eliv

ery

of ta

rget

ed

stra

tegi

es in

clud

ing:

• so

cial

mar

ketin

g to

edu

cate

and

in

form

the

popu

lati

on a

bout

he

pati

tis C

• in

form

atio

n re

gard

ing

prev

alen

ce

of h

epat

itis

C in

the

com

mun

ity

• in

form

atio

n re

gard

ing

the

natu

re

and

natu

ral h

isto

ry o

f chr

onic

he

pati

tis C

infe

ctio

n•

how

hep

atit

is C

is tr

ansm

itte

d•

how

hep

atit

is C

infe

ctio

n ca

n be

pr

even

ted

• th

e im

port

ance

of t

estin

g fo

r he

pati

tis C

• ne

w tr

eatm

ent o

ptio

ns.

Que

ensl

and

Hep

atiti

s C

Actio

n pl

an 2

016–

2021

Out

com

e1.

Impl

emen

t a c

ompr

ehen

sive

ap

proa

ch to

redu

ce h

epat

itis

C

tran

smis

sion

2. In

crea

se v

olun

tary

test

ing

fo

r hep

atiti

s C

3. In

crea

se tr

eatm

ent u

ptak

e

by p

eopl

e w

ith c

hron

ic

hepa

titis

C

4. In

crea

se a

war

enes

s of

he

patit

is C

tran

smis

sion

, an

d re

duce

stig

ma

and

disc

rimin

atio

n re

late

d to

he

patit

is C

Indi

cato

rsTh

e am

ount

of s

teri

le in

ject

ing

eq

uipm

ent d

istr

ibut

ed

Sour

ce: Q

ueen

slan

d N

eedl

e an

d Sy

ring

e Pr

ogra

m, C

omm

unic

able

Dis

ease

s B

ranc

h,

Dep

artm

ent o

f Hea

lth

Freq

uenc

y: A

nnua

l

The

prop

orti

on o

f peo

ple

who

inje

ct d

rugs

w

ho s

hare

inje

ctin

g eq

uipm

ent

Sour

ce: A

ustr

alia

n N

SP S

urve

y,

Kirb

y In

stit

ute

Freq

uenc

y: A

nnua

l

The

num

ber o

f opi

oid

depe

nden

t pe

ople

rece

ivin

g O

ST

Sour

ce: P

reve

ntio

n D

ivis

ion,

Dep

artm

ent o

f H

ealt

h Fr

eque

ncy:

Ann

ual

Prov

isio

n of

har

m re

duct

ion

init

iati

ves

in

cus

todi

al s

etti

ngs

Sour

ce: Q

ueen

slan

d Co

rrec

tive

Ser

vice

s Fr

eque

ncy:

Ann

ual

The

prop

ortio

n of

men

who

hav

e se

x w

ith m

en

who

are

inje

ctin

g dr

ug u

sers

, rep

ortin

g th

at

they

are

eng

agin

g in

saf

er in

ject

ing

prac

tices

Sour

ce: G

ay C

omm

unit

y Pe

riod

ic S

urve

y,

Cent

re fo

r Soc

ial R

esea

rch

in H

ealt

h Fr

eque

ncy:

Ann

ual

The

prop

orti

on o

f peo

ple

who

cur

rent

ly

inje

ct d

rugs

who

are

test

ed fo

r hep

atit

is C

Sour

ce: A

ustr

alia

n N

SP S

urve

y, K

irby

In

stit

ute

Freq

uenc

y: A

nnua

l

All P

HN

s pr

omot

e th

e pr

ovis

ion

of

hepa

titi

s C

test

ing

and

trea

tmen

t

Sour

ce: S

urve

y of

PH

Ns,

Com

mun

icab

le

Dis

ease

s B

ranc

h, D

epar

tmen

t of H

ealt

h Fr

eque

ncy:

Ann

ual

The

num

ber o

f AO

DS c

lient

s w

ith

a

hist

ory

of in

ject

ing

drug

use

und

erta

king

he

pati

tis

C te

stin

g

Sour

ce: S

urve

y of

AO

D s

ervi

ces,

Co

mm

unic

able

Dis

ease

s B

ranc

h, D

epar

tmen

t of

Hea

lth

Freq

uenc

y: A

nnua

l

The

prop

orti

on o

f peo

ple

diag

nose

d as

hep

atit

is C

ant

ibod

y po

siti

ve w

ho

subs

eque

ntly

hav

e te

stin

g to

det

ect t

he

pres

ence

of c

ircu

lati

ng v

irus

Sour

ce: E

xplo

re c

olle

ctio

n w

ith

Publ

ic

labo

rato

ries

, Que

ensl

and

Hea

lth

Freq

uenc

y: A

nnua

l fro

m 2

018

onw

ards

Deliv

ery

of a

pub

lic h

epat

itis

C

awar

enes

s ca

mpa

ign

Sour

ce: I

nteg

rate

d Co

mm

unic

atio

ns

Bra

nch,

Dep

artm

ent o

f Hea

lth

Freq

uenc

y: O

ne o

ff in

201

6

The

prop

orti

on o

f peo

ple

livin

g w

ith

ch

roni

c he

pati

tis

C re

ceiv

ing

trea

tmen

t

Sour

ce: M

onito

ring

hep

atit

is C

trea

tmen

t up

take

in A

ustr

alia

repo

rt, K

irby

Inst

itut

e Fr

eque

ncy:

Qua

rter

ly

All P

HN

s an

d H

HSs

have

col

labo

rati

ve

arra

ngem

ents

in p

lace

to e

nsur

e ti

mel

y lo

cal

acce

ss to

hep

atit

is C

trea

tmen

t

Sour

ce: S

urve

y of

PH

Ns,

Com

mun

icab

le

Dis

ease

s B

ranc

h, D

epar

tmen

t of H

ealt

h Fr

eque

ncy:

Ann

ual

Prov

isio

n of

chr

onic

hep

atit

is C

trea

tmen

t in

cus

todi

al s

etti

ngs

Sour

ce: S

urve

y of

Pri

son

Hea

lth

Serv

ices

, Co

mm

unic

able

Dis

ease

s B

ranc

h, D

epar

tmen

t of

Hea

lth

Freq

uenc

y: A

nnua

l

Prov

isio

n of

chr

onic

hep

atit

is

trea

tmen

t in

AOD

serv

ices

Sour

ce: S

urve

y of

AO

D s

ervi

ces,

Co

mm

unic

able

Dis

ease

s B

ranc

h,

Dep

artm

ent o

f Hea

lth

Freq

uenc

y: A

nnua

l

Impl

emen

tati

on a

nd e

valu

atio

n of

CBO

bas

ed

chro

nic

hepa

titi

s C

trea

tmen

t pro

ject

s

Sour

ce: F

unde

d se

rvic

e pr

ovid

er re

port

s

Freq

uenc

y: A

nnua

l

Cam

paig

ns in

pla

ce to

rais

e aw

aren

ess

of

hepa

titi

s C

in s

peci

fic s

etti

ngs

or a

mon

g sp

ecifi

c po

pula

tion

s co

nduc

ted

by fu

nded

se

rvic

e pr

ovid

ers

Sour

ce: F

unde

d se

rvic

e pr

ovid

er re

port

s Fr

eque

ncy:

Ann

ual

Que

ensl

and

Hep

atiti

s C

Actio

n pl

an 2

016–

2021

Queensland HealthQH 845 1611

HEPATITIS

HEPATITIS CACTION PLAN 2016–2021

QUEENSLAND

Queensland Hepatitis C Action Plan 2016–2021Published by the State of Queensland (Queensland Health), November 2016

This document is licensed under a Creative Commons Attribution 3.0 Australia licence.

© State of Queensland (Queensland Health) 2016

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