The epidemiology of hepatitis C in Australia: notifications, treatment uptake and liver transplantations, 1997-2006.
OBJECTIVE
Regular monitoring of hepatitis C (HCV)-related surveillance data is essential to inform and evaluate strategies to reduce the expanding HCV burden. The aim of this study was to examine trends in the epidemiology and treatment of HCV in Australia.


METHODS
We reviewed data about HCV notifications, treatment of HCV infection through the Highly Specialised Drugs (s100) Program, and liver transplants (Australia and New Zealand Liver Transplant Registry) for the period 1997-2006.


RESULTS
HCV case notification rates declined by almost 50% between 1999 and 2006, with the greatest reductions between 2001 and 2002 and amongst young adults. For newly acquired HCV cases, 89% were Australian-born and 90% reported injecting drug use as a risk factor for infection. Overall, 30% of liver transplant recipients had HCV-related cirrhosis, but the number and proportion of HCV diagnoses increased between 1997 and 2006. HCV treatment also increased over the review period. However, only 1.4% of the 202,400 people estimated to be living with chronic HCV at the end of 2006 received treatment that year.


CONCLUSIONS
The decline in HCV notifications is consistent with a decline in HCV incidence in Australia. However, the burden of advanced HCV disease continues to expand. To reduce this burden, treatment uptake needs to increase. Consistent and sensitive surveillance mechanisms are required to detect newly acquired cases together with an expansion of surveillance for chronic HCV infections.
National Centre in HIV Epidemiology and Clinical Research, Darlinghurst, NSW 2010, Australia. hgidding@nchecr.unsw.edu.au
Heather F
HF
Gidding
Libby
L
Topp
Melanie
M
Middleton
Kate
K
Robinson
Margaret
M
Hellard
Geoffrey
G
McCaughan
Lisa
L
Maher
John M
JM
Kaldor
Gregory J
GJ
Dore
Matthew G
MG
Law
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D018563:Disease Notification / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy* / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011159:Population Surveillance; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors; D055815:Young Adult
D000998:Antiviral Agents; D018937:Hepatitis C Antibodies; D012367:RNA, Viral