Hepatitis C - Multidisciplinary Panel

ASHM

Hepatitis C infection rose to notoriety in the same years as HIV infection and co-infection with the two viruses is common among people who inject drugs. Late HIV infection and Hepatitis B infection accelerate progression of HCV disease. About one half of injectors in Australia who participate in needle and syringe programs are HCV infected. There is little heterosexual transmission and little mother to child transmission. Greg Dore offered epidemiological evidence that hepatitis C in fifteen to nineteen year olds who inject drugs was rising and that girls and young women might be infected more easily than boys and young men. He suggested that this might be due to females beginning their injecting with older males who are already infected. HCV prevalence worldwide is high even in areas with low HIV prevalence. He postulated that harm reduction in Australia has had a bigger impact on HIV than Hepatitis C virus infection. What is beyond harm reduction? New demand reduction activities such as keeping young drug users from beginning injecting may be needed. Incarceration greatly increases the chances of infection so measures to prevent infection in prisons are critical. There may be other entry points for interventions that have not yet been explored.

Sandy Gifford showed that women infected reported that they had little post testing counselling, received advice to abort when they become pregnant, perceive their health to be worse than other women, and felt the discrimination of health care providers. Those who were past or current drug users perceive more discrimination. The links between discrimination against HIV infected people and those infected with HCV needs to be investigated. Jose Sasadeusz presented a synopsis of effective but expensive treatment approaches for people who have progressive Hepatitis C infection. Eric Downs reported that since there are no animal models, vaccine development is mainly proceeding with attempts to produce effective sub unit vaccines, virus like particles vaccines, or DNA vaccines. Few have reached the stage of trails.