Hepatitis C New Zealand

August 22, 2010

Hepatitis C Fear and Loathing, Biopsy vs. Fibro scan in NZ

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , , , — admin @ 6:13 pm

Fear and Loathing, Biopsy vs. Fibro scan in NZ

Ultrasound replaces painful liver biopsy surgery for hepatitis C patents in Auckland and Waikato

Painful biopsies have been replaced by an ultrasound technique the Fibroscan (a $200,000 machine) which provides a painless, non-invasive alternative to a needle biopsy by measuring the liver with ultrasound waves and evaluating progression of the disease.

“Obtaining liver tissue by a needle biopsy can be a very painful procedure resulting in bleeding, perforation of other organs, even hospital admission and, rarely, death,” Dr Weilert said.

“This has previously been the only option to assess the liver but the Fibroscan allows us to measure liver stiffness without invasive action.

“It will also allow us to map progress of liver disease better.”

The Fibroscan works through a probe held against the patients’ abdomen.

“The Fibroscan generates a pulse which sends waves through the liver, measuring its stiffness. The degree of stiffness in the liver indicates the amount of disease in the liver – so the greater the stiffness, the more disease there is”, adds Professor Gane.

“Because the Fibroscan procedure is so quick and easy we are able to see more patients in a shorter amount of time and patients no longer need to wait for months to start their antiviral therapy

The procedure takes about 15 minutes. There are currently machines in Auckland and Waikato

See below for Deliverable Three Undertake an analysis and develop a report on the utilisation of fibro scanning in New Zealand:

http://www.waikatodhb.govt.nz/news/pageid/2145843080
http://www.stuff.co.nz/waikato-times/news/1402330

Associate Professor Ed Gane Champion for HCV for the Ministry of Health.

Associate Professor Gane this year was appointed as Champion for HCV for the Ministry of Health.

In September 2005 a commitment was made by the government, to resolve the longstanding concerns of those infected with hepatitis C through the blood supply. Within this commitment a variety of measures were promised, including provision of an enhanced treatment package. Additional funding was sought and secured for this treatment package and a Hepatitis C Treatment Advisory group, comprising of clinicians, DHB managers and community representatives and chaired by Ed Gane was established to advise the Ministry of Health.

The terms of reference of the Hepatitis C Treatment Advisory Group were to develop a costed and prioritised Implementation Plan, supported by district health boards (DHBs) and the Ministry of Health. This group first met on 17 April 2007. During 2008, they conducted a comprehensive Stocktake of current HCV treatment services provided at each of the 21 DHBs. Following analysis of these results and other information, the committee identified barriers to accessing this treatment and geographical gaps in service provision. They identified priority interventions to improve services and patient outcomes throughout NZ and developed a costed and prioritised implementation plan for improving the access to and uptake of Hepatitis C treatment in New Zealand. The subsequent Health Report and the Hepatitis C Plan was submitted to Hon. Tony Ryall by HCTAG in January 2009.

On 28 July 2009, the Minister approved the “Strategic Directions for Hepatitis C – improving access to and uptake of hepatitis C treatment services” and signed off the funding allocation to address the key action areas within the document. These four key action areas, identified within Strategic Directions for Hepatitis C, are: (i) improving HCV treatment services;(ii) improving knowledge of HCV among primary health care providers; (iii) increasing the percentage of all people with HCV who have had the disease diagnosed; (iv) improving the knowledge of HCV prevalence in the New Zealand population and within subgroups.

Plans for primary care, including the new e-learning tool for GPs and Practice Nurses, designed to improve knowledge and encourage opportunistic screening for HCV.

Four Million Dollars Missing from New Zealand Hepatitis C Program

“A major component of the $30 million package announced in December last year is an additional $5 million per year to be invested to improve access to, and uptake of, hepatitis C treatment services. An advisory group has been established to assist the Ministry of Health and District Health boards improve hepatitis C treatment services to all people with hepatitis C, who are entitled to publicly funded health services.”
The ministry have now budgeted one million dollars for these service improvements wonder where the other four million promised went ?

So thirty million to pay for the New Zealand Ministry of health’s professionally incompetent advice and poor performance in protecting the blood supply.

Just one million of a promised five million to improve the situation and actually treat people

Four million dollars just disappearing I get the feeling this is another colossal ministry cost cutting mistake in the making how expensive is this poor health policy going to be in the long term ? time will tell.

Note : To get our (www.hcv.org.nz) copy of the Strategic Directions document we had to write many  Official Information act requests. The Ministry of Health who subsequently lied about our requests to the ombudsman (and were stupid enough to get caught lying) had withheld it for over a year. Now where do you think the Ministry tell people to go to get a copy of the “Strategic Directions for Hepatitis C – improving access to and uptake of hepatitis C treatment services”  Well here to  peer based organisation that has no funding www.hcv.org.nz we are hosting Strategic Directions for Hepatitis C document and the only place it’s available, their key document for a million dollar tender W.T.F.

What the ministry want to buy for one million dollars to improve access to and uptake of hepatitis C treatment services

The Ministry is seeking a Provider to deliver the following services for individuals with Hepatitis C:

• appropriate referral from primary care to secondary care via use of a standardised tool;
• provision of integrated care for those diagnosed but untreated or discharged following treatment via use of a shared care clinical tool / protocol;
• equitable access to fibro scanning for diagnosis;
• improved information resources for specific ‘at risk’ population groups; and
• improved detection, access and treatment service delivery models.

The following services are being purchased:

Deliverable One
Develop, consult and disseminate nationally into primary care a standardised referral tool / form from primary to specialist care.
Deliverable Two
Develop, consult and disseminate nationally across providers, a shared care clinical tool / protocol, for the provision of integrated care / management for:
Deliverable Three
Undertake an analysis and develop a report on the utilisation of fibro scanning in New Zealand including:
Deliverable Four
Develop, consult and disseminate nationally education / information resources for specific sub-population ‘risk’ groups including:

Development of a plan for targeted testing will enable implementation of more effective detection and treatment of at risk groups.
Deliverable Five
Research and provide a feasibility report for a potential three-year programme to promote
the targeted testing of specific ‘at risk’ groups to improve early HCV diagnosis rates and
treatment options for these individuals.
Deliverable Six
Undertake research and development of innovative HCV service delivery model(s) for New Zealand:

(If you want a copy of full tender document you have to go to NZ government GETS site and register )

So if you want a slice of the pie get your applications in It looks like a bunch of stakeholders have tried to carve up the funding pie in to neat little segments only time will tell how effective this will be.

Epidemiological ongoing measurement of the spread of Hepatitis C actually gets a special mention in Strategic directions document but seems to have been completely ignored in the proposal for services. I just wonder where the evidence base for this spending is coming from if we don’t accurately count the epidemic on a ongoing basis?

I would like to have seen money spent on measuring the epidemic more accurately, although as there seems to be an emphasis on meshing the diagnosis / treatment and care of hepatitis C in to a new national GP information system, may be this will also count the spread of the epidemic ?

Looks like we are going to get more community clinics (Deliverable Six) because we need to duplicate treatment services, New Zealand being awash in spare health funding we can afford this ? Most of the country has no access to support services. Wellington Waikato and Invercargill no resources no support services with rural NZ getting the big nothing.This inequality of access to support needs to be addressed on a national basis rather a than a few regions.

We are farming the newly infected from ineffective  needle exchange programs that grow the epidemic , on to community clinics at needle exchanges delivering treatment, a win win situation for needle exchanges as far as capturing  health resources.

This development of a duplicate service to serve the needs of IDU (intravenous drug users) would be better addressed by educating health professionals on how to best to care for and not stigmatize IDU using existing resources  rather than developing a expensive  duplication of resources.

Well the next six months should reveal the shape of hepatitis C improvements so I guess that is progress and I should be a bit more positive about it. Fingers crossed something good happens.

Stop people dying needlessly

My favourite way of testing and diagnosing the majority of individuals who are no longer if ever active drug users would be the English system of pharmacy testing which has proved much more successful that GP based testing.
Last year a viral hepatitis testing pilot project in 19 pharmacies across the country has found a hepatitis B or C positive patient in every 6 tests conducted. Across the pharmacies a total of 234 tests were conducted, diagnosing 35 people with hepatitis C (15% of tests) and 4 people with hepatitis B (2% of tests). This is a far higher proportion of hepatitis C positive diagnoses than found in GP surgeries, where 4% of tests find positive hepatitis C patients and 2% of tests find hepatitis B patients.

Charles Gore, Chief Executive of The Hepatitis C Trust said: “It is a tragedy that increasing numbers of people with hepatitis B and C are dying, often from particularly unpleasant liver cancer which these viruses can cause. It is a tragedy because they have generally been living with the virus for years and could have been given treatment at any point, if only they had been diagnosed. So we desperately need new approaches to testing that will find the undiagnosed patients and this pilot study shows pharmacy testing could be just what is needed.”

“If the pharmacy testing pilot is taken as a model and rolled out by PCTs and pharmacies nationally, we can stop people dying needlessly.”

The Isle of Wight continues to offer these tests after the end of the pilot scheme and has extended it to include added HIV and syphilis tests from the same sample as the viral hepatitis screen. When asked, Gary Warner from Regent Pharmacy on the Island said:

“The results speak for themselves - pharmacies see a different cohort of people to those who see their GP and therefore we can access and diagnose people who otherwise would not have been tested. As an example, the patient that was screened as HIV positive was not someone who would have accessed the test in any other way.”

http://www.medicalnewstoday.com/articles/198364.php

press video here

http://www.youtube.com/watch?v=iG49NTOvOEU

best of health

www.hcv.org.nz

July 23, 2010

100% Pure New Zealand Hepatitis C

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , — admin @ 4:24 am

100% Pure New Zealand Hepatitis C

Who do I have to tell if I have Hepatitis C In New Zealand?

Hepatitis C and Disclosure

Someone asked about Hepatitis C and disclosure

With some help from the Hepatitis C resources Centre Dunedin and the New Zealand

Ministry of Health the definitive reply seems to be.

DISCLOSURE
A person with hepatitis C is not legally required to disclose his/her positive

status unless he/she is,
*A member of, or applying to join, the New Zealand defense force.
*A healthcare worker undertaking exposure-prone procedures.
*Donating blood.

Page 19 of the little yellow book of Hep C Facts,:

If you would like a copy of   the little yellow book of Hep C Facts ring

Hepatitis C Helpline New Zealand 0800 224372 (0800 22 HEPC) or email  the Otago

Hepatitis C Resource Centre hepcotago @xtra.co.nz

Hep C Concert Christchurch

Thank you to Roger Grauwmeijer Rokpx.com Roger@RokPx.com for the images from the day May 22 concert in thepark

chch11

chch82

Dunedin opened it’s new Hepatitis C resource centre

photos were taken speeches were made.

hepcopen2

An article about the opening and the centre’s worker Heath Te Au appeared in the

Otago Daily Times,

” Fresh chance inspires hepatitis C educator

Having a ruptured appendix in the 1990s may have helped save Heath Te Au’s life.

Blood tests taken at the time of this medical emergency showed that he had hepatitis C, most likely the result of sharing needles and drug equipment during a time when he was an intravenous drug user.

After his appendix removal a doctor asked him to think about what he was doing to himself.

Mr Te Au (40) said it was a wake-up call, something which led him to change his life.

He underwent treatment in 1999 and 2000 and is now clear of the blood-borne virus which had been caught early enough not to cause major liver damage.

Now, he uses his experience to help educate others in his role as manager and one of two educators at Otago’s Hepatitis C Resource Centre. ”

Where are the Hepatitis C Resources for Wellington ?

A very large proportion of the population have no access to hepatitis C resources

its’ dysfunctional and emphasis the New Zealand’s Ministry of Health’s complete

failure to address the needs of those affected and infected by the Hepatitis C

epidemic.

The New Zealand Ministry of health attempts to contact the victims of Croydon Day Clinic

Hep C tracking hampered by privacy issues

Health authorities have tested more than half the women in New Zealand potentially exposed to the hepatitis C virus in a Melbourne abortion clinic, but are being hampered by confidentiality rules which mean they cannot leave phone messages.

Fifty-six New Zealand women have called the Ministry of Health’s Healthline, concerned they had contracted the virus after James Latham Paters, an anaesthetist at Melbourne’s Croydon Day Surgery Clinic was now being investigated by police and medical authorities. More than 20 of his patients tested positive to a strain of hepatitis C identical to his own.

“The Australian Victorian health authorities have contacted 33 New Zealanders and the bulk of those have been tested,” said the ministry’s director of public health, Fran McGrath.

The New Zealand test result figures would be released as part of the Australian report once the contacting and testing process was completed. The ministry expected to have a further update in September.

Dr McGrath said contacting the women was a slow process because confidentiality requirements meant callers could not leave messages and had to repeatedly ring back.

“Even contacting one individual can take several calls followed by a registered letter, all of which can take a considerable period of time.”

http://www.stuff.co.nz/national/health/3918567/Hep-C-tracking-hampered-by-privacy-issues

Hepatitis C Resource Centre Otago Stakeholders Meeting June 16

Hep C Seminar Dunedin

Insights offered on hepatitis C, services

“Recent concern about the risk of hepatitis C to women who may have been treated at a private medical clinic in Melbourne highlights the need for increased awareness about the illness, clinical nurse specialist Margaret Fraser says.

Ms Fraser, who is the chairwoman of the reference group for Otago’s Hepatitis C Resource Centre, said there was still widespread ignorance about the condition.

http://www.odt.co.nz/news/dunedin/110725/insights-offered-hepatitis-c-services

After sorting out my family commitments I arrived late at 9.20 so missed the

Opening / powhiri ,  Heath Te Au , Hepatitis C Resource Centre Otago who works as

a phlebotomist and the needle exchange and Margaret Fraser the hepatitis c nurse

from Dunedin Hospital speaking about  Epidemiology and treatment of Hepatitis C

apologies that I missed them speaking.

Dr Janet Downs from the free doctor’s clinic at DIVO the Dunedin needle exchange

talked about  Hepatitis C in the community. She spoke eloquently about her work

at the needle exchange, if you live in Dunedin / Otago and want to see her at the

needle exchange free clinic for IDU Intravenous Drug Users ring the needle

exchange and make an appointment

Dr Michael Schultz, Hepatitis C and what happens if you decide against treatment

was the next speaker.

Key points  “everybody should be treated the earlier the better”

The younger you are when you begin treatment the better chance of a successful

outcome

There were some unique and disturbing aspects to the policy ?  of the Southern

District Heath Board

1, people are not able to get a second course of treatment if the first course

fails to successfully clear the hepatitis c virus.   One strike and you’re out

this just seems to be harsh when retreatment is an option in other DHB’s.

2, You have to have a biopsy in the Southern region ( Dr Schultz couldn’t

understand why anyone would complain about a biopsy as they obviously didn’t have

a problem with needles?)

A professional contact sent us this, “I contacted leading  NZ specialist expert

to clarify who needs a biopsy and who doesn’t.   Here is the response: “We have

never needed a biopsy for Gt 1 or HIV infected or haemophilia.  Only change is

for Gt 2 and 3 where now Peg/RBV is available to all rather than just those with

severe fibrosis.”
In the past only G2/G3 who has severe fibrosis could access funding, therefore

for this to be determined, a liver biopsy was needed.  The new funding for

treatment now includes all G2/G3 hep C patients; hence a liver biopsy may not be

necessary.
Interesting sounds like you may not have to have a biopsy in other DHB’s.

If a liver biopsy is a barrier to accessing treatment for some people (I think it

is) we would be better to remove it in some cases ?

Merrilee Williams RN, Otago hepatitis C nurse spoke about treating Hepatitis C

next she was knowledgeable and gave a informative presentation.

Michelle MacDonald, Psychiatric Liaison spoke on treating people with Hepatitis

C
and the neuro psychiatric effects of treatment

Depression
Fatigue
Irritability
Insomnia and sleep disturbances

She explained that preexisting mental health issues can and need to be treated

before treatment

Once these conditions are being treated they do not preclude someone from

successfully undertaking treatment.

Bill Jang, Christchurch Hepatitis C Resource Centre Te Waipounamu arrived by

helicopter (well maybe not, but he made a very brief appearance and then left) ,

he made the interesting point that the recent international 1 in 12 hepatitis

campaign was  actually one in forty New Zealanders have hepatitis B or C.

He has begun educating rest homes on Hepatitis C care.

Shame the needle exchange DIVO wasn’t there to advocate for their clients but

again they to seem to be uninterested in their client’s access to care or issues

surrounding Hepatitis C. Not surprising when the local needle exchange is now

entirely governed  and run from Christchurch as a skeleton service.

Wonder how that works with the Ottawa charter on public health. Best just ignore

best practice for public health and instead have our poorly performing health

services controlled from Christchurch.

The good news is there has been an increase in the number of people being treated

in Otago from 24 to 40. I imagine this is the people with genotype three who are

finally getting treatment after Pharmac changed the funding for treatment for

their genotype finally making it accessible.

If we do the calculation that 1% of Otago population has hep c a figure of 1800

people and the Otago/ Southern ? District Heath board treat 40 per year, we can

calculate that in just 45 years everyone would be diagnosed and treated.

Maybe Bill Jang is right about rest homes, assuming the undiagnosed infected live

that long.

It was a good opportunity to see Hepatitis C discussed in the community in such a

positive way a great morning well done to the organisers.

Their were lots of info  / pamphlets available and I picked up a glossy A4 brochure from Roche aimed at raising awareness amongst NZ General Practice Doctors which has to be a good thing.

You and Pegasys Together we can cure hepatitis C Identify and refer patients today.

gptogethercover

Roche pamphlet targeting GP’s.

With 75 % of hepatitis C patients undiagnosed it seems a timely resource

Each New Zealand GP practice on average would have 15 patients.  Most undiagnosed

and untreated.

txtrochegp

North Island Hepatitis C Resource Centre (Te Ika a Maui)

I just found this website for the North Island Hepatitis c Resouce Centre I’m

guessing it’s the replacement for the old site that seems to have disappeared the

Hepatitis C Resource Centre (Te Ika a Maui)   http://www.hepcresources.org.nz/

put on your sunglasses it’s bright with all those virus floating round.

pegypen

Best of Health

www.hcv.org.nz

May 11, 2010

New Zealand World Hepatitis Day, May 19 2010

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , , , , , , , , , , , , , — admin @ 5:21 pm

New Zealand World Hepatitis Day, May 19 2010  update

A couple of events for world Hepatitis month here in New Zealand

Hepatitis Free concert in Latimer Square Christchurch May 22 nd 11 am – 4 pm

The Hepatitis C Resource Centre Te Waipounamu in conjunction with World Hepatitis Day  proudly present a free concert in Latimer Square Christchurch Saturday May 22 nd 11 am – 4 pm info stalls, Sausage Sizzle,bouncy castle, byo picnic

Lots of Bands Squirm , Dialtones , Mynor Starr ,Anthesiac, Magic Eye, Anthesiac,Papanui High School Jazz combo, ChisnallwoodIntermediate Bands Vivid Distortion, Chain Reaction, Closing Time, 1.5l sprite bottle, DJ Detox Damage.

hepc-gigposter2010
further details contact Hepatitis C Resource Centre Christchurch phone 3663608  email hcv @xtra.co.nz

Opening of the new Hepatitis C Resource Otago Centre office May 19 2010

A great day out in Christchurch and if you make it to the event watch out for  Hepatitis C Resource Centre Dunedin phlebotimist Heath in his band,  Heath will be back in Dunedin on 19 May for the opening of the new Hepatitis C Resource Centre office in Dunedin.

further details contact Heath and  Allison at Otago  Hepatitis C Resource Centre hepcotago @xtra.co.nz

The past month has seen a lead up campaign of  one in twelve hepatitis  awareness ads played nationally on TV 3

best of health

www.hcv.org.nz

March 8, 2010

Hepatitis C New Zealand Blog March 2010

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , , , , , , , , , , , , , — admin @ 3:29 pm

Hepatitis C conference  Whakatane 2010

Past Failures and New Solutions in Hepatitis B and C control in New Zealand and the Asia Pacific region
Tariana Turia - NZ Viral Hepatitis Conference 2010

Tuatahi me mihi atu ki te mana whenua. Tena koutou o Mataatua waka. Tena hoki koutou o nga mata waka kua whakarauika nei i raro i te karanga o te ra

Tena koutou i runga i te rangimarie. Tena koutou i runga i nga maharatanga mo ratou kua wheturangitia.

No reira, tena tatou katoa

I want to thank the Hepatitis Foundation of New Zealand for the honour of being invited to open this third New Zealand Viral Hepatitis Conference.

I acknowledge the local people of this rohe, and I thank them for their generosity in hosting us here in Whakatane.

I extend a particular welcome to our international guests:

* Professor Mitchell Shiffman from the United States;
* Professor Andrew Lloyd from Australia;
* Dr Morris Sherman from Canada and
* Dr James Fung from Hong Kong.

While both Hepatitis B and C viruses are notifiable conditions under the Health Act, it is only cases of acute infection which require to be notified to the Medical Officer of Health.

Alongside with the lack of awareness that comes from being asymptomatic; people with hepatitis may experience stigma and discrimination which compounds the problems of living with the virus.

So the call to do better is an important one.

We must continue to raise awareness, leading to increased testing and diagnosis.
Well spoken words from Tariana Turia

Life after liver transplant

Hi, This is my first post of my Video Diary following my Liver Transplant and my continued fight against my Hepatitis C infection/virus. Just a quick one to saay hello - I’ve never done video before and so let’s hope for all our sakes that I get better at it soon!

Please check out my blog: http://www.ianquill.blogspot.com - Thanks for watching…. Ian Quill

Hepatitis C Drug Trails NZ March 2010

Four drug trials for Hepatitis C in New Zealand at the moment (March 2010)
http://clinicaltrials.gov/ct2/results?term=hepatitis+c+New+zealand&recr=Open
1, TMC435-TiDP16-C206: A Safety and Efficacy Study in Chronic, Genotype 1, Hepatitis C Patients That Failed Previous Standard Treatment

2,  A Safety and Efficacy Study of the Combination of VX-222 and Telaprevir in Treatment-Naïve Subjects With Genotype 1 Chronic Hepatitis C Virus Infection

3, Safety and Tolerability Study of Clemizole Hydrochloride to Treat Hepatitis C in Subjects Who Are Treatment-Naive

4, Antiviral Activity of AZD7295 in HCV Carriers

Doctor  Magdalena Harris

thesis is available online now

Negotiating the pull of the normal: embodied narratives of living with hepatitis C in New Zealand and Australia (2010)
Harris, Magdalena , National Centre In HIV Social Research, Faculty Of Arts & Social Sciences, UNSW
My status as a person living with hepatitis C informed all aspects of this research project; I therefore also include my own experiences, foregrounding researcher reflexivity and the co-constructed nature of the interview process.

“ My aims are both practical and theoretical. On a practical level I explore the experiences of people living with hepatitis C in order to inform recommendations for policy, research and practice, while also working to elucidate and employ an approach that allows for an analysis of the ill body as a lived experiencing agent, located in a substantive web of connections whereby discourse, corporeality and sociality, inform and mediate one another. To this end I employ a “political phenomenology” influenced by phenomenological and poststructuralist theoretical approaches. The central, previously under-researched, issues that arose in participants’ narratives structure the chapter outline, with results chapters focusing on participants’ experiences of diagnosis, living with hepatitis C, stigma, support group membership, alcohol use, and hepatitis C treatment.

For many participants, it was found that living with hepatitis C was a liminal experience where distinctions between what it was to be healthy or ill were not clear-cut. Indeed, many of the participants’ narratives exposed the inadequacy of Western binary categorisations to speak to their experiences of living with hepatitis C. Throughout this thesis it can be seen that the meanings that participants ascribed to health, illness, and their hepatitis C were fluid and contextual, informed by the interplay of corporeality and discourse. From this interplay comes the ability to speak into the gaps of dominant discourses, creating the potential for the disruption, or subtle realignment, of normative ways of knowing. “
Download  your copy here
http://unsworks.unsw.edu.au/vital/access/manager/Repository/unsworks:7899

Congratulations  Dr Harris from all your peers.

The best of health
www.hcv.org.nz

January 30, 2010

Hepatitis C New Zealand blog January 2010 New Zealand Viral Hepatitis Whakatane 2010

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , — admin @ 4:49 pm

Hepatitis C New Zealand blog January 2010 New Zealand Viral Hepatitis Whakatane 2010

New Zealand Viral Hepatitis 3rd NZ Conference Whakatane 2010

Friday 05 March – Saturday 06 March 2010
War Memorial Complex, Whakatane, New Zealand

Invited Speakers: Professor Mitchell Shiffman, USA

Professor Andrew Lloyd, Australia

Dr Morris Sherman, Canada

Dr James Fung, Hong Kong

Around half the conference will  be about hepatitis B and the other half hepatitis C

With topics such as

Relevance of viral  load; is it a predictor to HCC?  James Fung

Multidisciplinary approach of HCC in NZ  John McCall or Adam Bartlet

Therapies available for patients with HCC in NZ Catherine Stedman

State of the Art Lecture

Optimisation of Outcomes with current standard-of-care” (on use of baseline and
on-treatment responses (RVR, EVR) to individualiase therapy, weight-based RBV).
What’s next – direct acting antivirals (DAAs )Mitch Shiffman

HCV in Correctional Facilities

HCV prevention, treatment and follow-up in prison populations Andrew Lloyd

HCV in NZ correctional facilities Frank Weilert

NZ model in an Auckland prison Steve Gerred

Difficult-to-treat patients

State of Art Lecture
“Approaches to non-responders – retreatment, induction dosing IFN,
higher dosing RBV, maintenance therapy – do they work”  Mitch Shiffman

Alternative therapies for HCV

Is there alternative therapies for HCV treatment and do they work? TBA;   College of natural therapies

Middlemore audit of patients taking alternative therapy Jacinda Ryan

Hepatotoxic therapies Sarah Fitt

Debate: Should there be a national register for chronic HBV & HCV?

You can find out more about the conference at the hepatitis foundation of New Zealand Website here

http://www.hepfoundation.org.nz/conferencep.html

and register here

http://www.hepfoundation.org.nz/RegistrationForm2010.pdf

Our invite must have got lost in the mail and our budget of zero precludes travel. The joys of the peer based NGO.

New Zealand hep c news letter

Got my first email copy of the New Zealand hep c news letter , a joint effort by the Auckland Christchurch and Dunedin Hepatitis C Resources centres.

Well actually I accidentally deleted it so if you want to check it out Hepatitis C resource centre  0800 224372 (0800 22 HEPC)

A viral hepatitis testing pilot project in 19 pharmacies across the country has found a hepatitis B or C positive patient in every 6 tests conducted.

I mentioned this chemist based anonymous testing for hepatitis at English pharmacies a while back; the results of the trial have been interesting

19 pharmacies in 5 PCT areas offered free, on-demand hepatitis B and C dried blood spot tests to clients who had been at risk of contracting viral hepatitis as part of a 3-month pilot project organised by The Hepatitis C Trust. Across the pharmacies a total of 234 tests were conducted, diagnosing 35 people with hepatitis C (15% of tests) and 4 people with hepatitis B (2% of tests). This is a far higher proportion of hepatitis C positive diagnoses than found in GP surgeries, where 4% of tests find positive hepatitis C patients and 2% of tests find hepatitis B patients.

Dev Dalvar from D R Pharmacy in Sandwell PCT commented on the pilot: “Offering hepatitis B and C tests in my pharmacy has been a huge benefit to the local community. The people diagnosed will now be able to access potentially life-saving treatment and many customers are more aware about the viruses and risk factors.

Charles Gore, Chief Executive of The Hepatitis C Trust said: “It is a tragedy that increasing numbers of people with hepatitis C are dying, often because they have been living with the hepatitis B or C undiagnosed for years, even decades. There are at least 100,000 people living with the hepatitis C unawares but only 8,000 people were diagnosed last year. We desperately need a new approach to testing that will find the undiagnosed patients and this pilot study shows pharmacy testing could be just what is needed.

A series of Hepatitis C videos from the Harm reduction works

HIV, hepatitis C and injecting drug use, part 2: The sharing of injecting equipment

Best of health for 2010

www.hcv.org.nz

July 8, 2009

Hepatitis C New Service Improvements “delayed”

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , , , , , , — admin @ 2:24 pm

In the 2009 Health Budget

Savings can be generated in 2008/09 and 2009/10 by delaying contracting for services from within the draft Hepatitis C plan that have not yet been agreed and provided.

We don’t get ?

These are likely to include information and education services and DHB/Primary Care treatment services.

We get ?

  • A clinic in Christchurch for a three year proof of concept pilot programme to trial the provision of a Community Clinic
  • evaluation of the Christchurch clinic pilot
  • Haemophilia Foundation New Zealand - contracts to discharge obligations made under the Government’s Hepatitis C no-fault decision.

Hep C Service Improvements Cancelled

I think this is entirely unacceptable for the magnitude of the epidemic we are dealing with. Somebody does not get it.

We get a  Community Clinic in Christchurch that duplicates existing services in a community, that already has two treatment providers ?

We don’t  get information and education services and DHB/Primary Care treatment services for the rest of the country.

Which option benefits the most individuals and communities ?

What is going to make the most difference to the Hepatitis C epidemic in New Zealand ?

Christchurch Community Hepatitis C Clinic who is  it ?

Needle Exchange New Zealand, the Hepatitis C Resource Centre and Rodger Wright Needle Exchange Programme. A smoggy triangle of organisation’s based in Christchurch came up with the idea of a clinic for Christchurch.

The clinic will be governed through the Drug Injecting Services in Canterbury Trust which operates as the Rodger Wright Needle Exchange.

Christchurch PHOs, Partnership Health , Canterbury Community and Ministry of Health have provided financial assistance to support  the clinic .

If the Christchurch pilot proves successful, it is hoped similar clinics will be rolled out in other centres.

Christchurch already had a good level of hepatitis C treatment already according to the Christchurch DHB read more here


Where is the famous hepatitis C Plan ?

We have seen the mess that exiting servcies are in and it now seems a solution has been postponed. Yet we can’t even see this mythical Hepatitis C  plan to see what has been cut .

INVEST IN HEPATITIS C TREATMENT

It saves money you ,  It costs more to not treat, not addressing the problem is ensuring the future costs grow with the epidemic.

Health Economist, Ian Sheerin, from the National Addiction Centre at the Christchurch School of Medicine and Health Sciences says the lack of strategic screening, management and treatment for IDUs with Hepatitis C will cost the country dearly in coming years. He says there will be a multiplier effect in terms of increased health costs through extra GP visits, diagnostic tests, hospital outpatient follow-up, and inpatient admissions for liver cirrhosis and liver transplants.

“The figures should be of concern to health planners. There has been little official recognition of the implications of these escalating costs which will run into many millions of dollars in future,” says Ian Sheerin. ” My research predicts that there will be a cost of between $166 and $400 million over the next 30 years because of a lack of adequate treatment of Hepatitis C at present.”

Ian Sheerin says there is also the attitude amongst some members of the public that drug users don’t deserve any treatment at all. He says this is short-term thinking that will rebound on the taxpayer as more intravenous drug users end up in hospital with complications as a result of advanced Hepatitis C infection. With Hepatitis C, early intervention is arguably the most rational economic course to follow, resulting in fewer cases of severe liver disease while benefiting the patient at the same time.

Ian Sheerin National Addiction Centre Christchurch School of Medicine and Health Sciences University of Otago

Instead of making savings. These delays / savings in the 2009 budget  are generating greater future costs.

best of health

www.hcv.org.nz

April 30, 2009

How many people in New Zealand have Hepatitis C ?

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , , , , , , , , , , , — admin @ 3:55 pm

How many people in New Zealand have Hepatitis C ?

holiday

The often quoted 50,000 New Zealanders’ with HCV figure derives from a study, Hepatitis C infection in New Zealand: Estimating the current and future prevalence and impact July 2000

The objective of this project was to estimate the number of people in New Zealand who are currently infected with the hepatitis C virus (HCV) and how many are likely to become infected up until the year 2010. It also aimed to project how many people are expected to develop HCV-related liver disease.

The study uses a model developed by the National Centre in HIV Epidemiology and Clinical Research in Australia. The model was modified to reflect the epidemiology of HCV infection and injecting drug use in New Zealand. It is based on estimating the number of people who have used injecting drugs over time and determining the incidence of HCV as a result of this. These estimates were adjusted for transmission from other routes including the receipt of HCV-infected blood and blood products.

The estimates and projections from the model must be interpreted with caution as there are limited New Zealand data for the input variables of the model.

So lots of assumptions later and with lots of qualifying statements we have the guesstimate of 50,000 Zealanders’ with HCV the truth no one knows ?

Australian study

An Australian led, international clinical trial, being presented at the European Association for the Study of the Liver Congress in Copenhagen this week has highlighted the benefits of treating hepatitis C sooner, rather than later.

The study involved more than 700 Australians with hepatitis C and 33 Australian hospitals. It found people living with the most common strain of hepatitis C who receive treatment when there is minimal, or no liver damage, may double their chance of a cure, compared to those treated in the later stages, where liver damage has become more advanced.

“We found that that up to seven out of ten people, with the most common strain of hepatitis C (called genotype 1), may be cured if treatment starts before liver scarring or damage has occurred.”

Associate Professor Stuart Roberts, Director of Gastroenterology and Hepatology, The Alfred Hospital, Melbourne

More here

Christchurch Hepatitis C Community Clinic

Christchurch Hepatitis C Community Clinic, Information about clinic and interview with nurse Jenny Burke and from Christchurch Hepatitis C resource Centre in their Connexion magazine reproduced here.

http://www.hcv.org.nz/christchurchclinicjbourke.html

The clinic has opened in partnership with the Christchurch needle exchange, The Rodger Wright Centre. Personally I would rather go to a GP / hospital to access health services.

I was at a party recently when a old friend approached me and told me about getting a blood test at one. She was not impressed, She is in recovery (staunch NA person lots’ of regular meetings etc) she described the experience as making her feel like a junky again and that the person couldn’t get a blood sample from her despite numerous tries.

For people who are immersed in the sad reality of drug use Community Clinics may be the only way they can access health care and it is important to cater for these disadvantaged groups if we are to effectively address Hepatitis C epidemic in New Zealand.

The claim it is the first community hepatitis C clinic in NZ is somewhat dubious as it appears to offer no treatment just referrals for treatment.

The European Association of the Study of Liver Disease wrapped up on Sunday in Copenhagen. Some new drugs and studies revealed at EASL in Copenhagen EASL , here are some of the highlights of all things hepatitis C including

Roche, InterMune(ITMN Quote) and Pharmasset(VRUS Quote) provided the most eagerly anticipated clinical data of the conference Saturday with results from a 14-day trial combining two experimental direct antivirals — InterMune’s ITMN-191 with Pharmasset’s R7128 — given to patients with treatment-naïve hepatitis C. Roche is a development partner on both drugs.

telaprevir is capable of significantly improving cure rates in the most difficult-to-treat patients who had failed prior treatment with the current standard drug regimen for hepatitis C — a 48-week course of long-acting interferon plus ribavirin.

This data keeps telaprevir ahead of its hepatitis C rivals because no other drug has yet shown the ability to improve the cure rates for both patients new to therapy as well as those who have failed prior therapy.

Telaprevir was the “butt” of some negative EASL chatter due to an anecdotal report that the drug was causing severe anal itching in patient(s). One EASL attendee described the side effect as “fire in the hole.”

More here

http://www.thestreet.com/story/10492231/1/hepatitis-c-updates-from-easl-liver-confab.html

World Hepatitis Day coming up Tuesday, May 19, 2009

www.hcv.org decided to celebrate World Hepatitis Day by finding out how many people in New Zealand are treated and what level of care and treatment and support is available.

We sent letters to all District health boards and are hoping to get back replies and post them up in next month or so.

It is inspired by a recent study of Asthma care in NZ http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10556507

Otago and Canterbury were done earlier and their replies here.

http://www.hcv.org.nz/CHCHOIA08.html

http://www.hcv.org.nz/otagoaudit08.html

Best of Health

www.hcv.org.nz

March 20, 2009

Hepatitis C New Zealand Pharmac widens access to Interferon,Christchurch Community Hepatitis C Clinic

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , , , , , , — admin @ 3:21 pm

Hepatitis C New Zealand  Pharmac widens access to Interferon

March 9 2009

Good news from PHARMAC, who manage New Zealand Government expenditure on pharmaceuticals.

Access widened to pegylated interferon for hepatitis B and hepatitis C genotypes 2 and 3

A widening of existing subsidised access to include patients with chronic hepatitis C, genotype

2 and 3 who do not have cirrhosis.

Provision of subsidies for patients with chronic hepatitis B, where patients are treatment Naïve;

ROCHE products Pegasys and Pegasys RBV Combination Pack will be the sole supply brand of pegylated Interferon and pegylated interferon and ribavirin combination packs until 31 December 2012.

Delisting of Schering Plough product Pegatron, from the Pharmaceutical Schedule.

There will no longer Schering Plough, Pegatron products available cutting out one treatment option that has been used in the past for people who have been unresponsive to Roche products?

Pharmac site has more details  and prices for pegylated interferon in New Zealand

Christchurch Community Hepatitis C Clinic

I missed this news when it came out but a notable moment in community health was the opening of Christchurch Community Hepatitis C Clinic, New Zealand’s first free community hepatitis C clinic

Nurse and hepatitis C specialist Jenny Bourke will run the clinic. Bourke urged anyone who thought they might have hepatitis C to go to the “discreet” Manchester St clinic for a check. “We want to get people checked out as soon as possible so they don’t get things like cirrhosis of the liver or other liver damage,” she said.

www.stuff.co.nz

TO contact Christchurch Community Hepatitis C Clinic contact Christchurch Hepatitis C Resource Centre 0800 224372 (0800 22 HEPC)

Indonesia 12 million with Hepatitis C

The Jakarta Post | Mon, 03/16/2009 11:25 AM | National

Indonesians are becoming increasingly more vulnerable to cancer of the liver, with more than 40,000 new cases detected each year, health experts warn.

“Around 42,600 new cases of liver cancer occur every year in the country,” health expert Terawan Agus Putranto said Saturday during a seminar on cancer diagnosis and therapy in Jakarta.

“Most of the cases stem from hepatitis, which is a prevalent disease among Indonesians,” added the radiology specialist from Gading Pluit Hospital in North Jakarta.

He said careless use of needles and unmonitored blood transfusions had contributed significantly to the spread of hepatitis, which is transferable through blood, faeces and sexual contact. Indonesia has Hans U. Baer, an expert on cancer-related abdominal surgery, told the forum that hepatitis was a disconcerting issue in Indonesia, with around 10 percent of the country’s 240 million people exposed to the Hepatitis A virus, 5 percent to the Hepatitis B virus, and another 5 percent Hepatitis C.

Best of health

www.hcv.org.nz

September 11, 2008

Who to tell Hepatitis C and disclosure ?

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , — admin @ 6:44 am

 hcvdisclosure.jpg                                             Hepatitis C is a disease with a attached stigma for many of past drug use and for others who    have contracted Hepatitis C in other ways they still must deal with a perception of past drug use.

For some people, disclosing (or telling others) that they have hepatitis C is not easy.

You may be worried that you will be treated differently once people know you have hepatitis C.

It’s a personal choice lets consider some of the issues involved.

Perhaps you will be discriminated against?

Maybe your friends will no longer want to be around you?

Will you lose your job or be treated differently at work?

It is important that you find out as much as you can about hepatitis C before you tell others. Giving people accurate information about hepatitis C (including booklets, pamphlets and information from the Internet) often helps correct wrong ideas they may already have about hepatitis C, and people with hepatitis C.

A positive, supportive response is the best outcome, but you might also get a negative reaction, and it’s important to be prepared for this. If this happens, remember that it is because of the beliefs and understandings of the person you have disclosed to. People react the way they do because of the information (or lack of information) they already have about hepatitis C and people with hepatitis C, and their beliefs about that information.

There are benefits in telling people you have hepatitis C.

Friends and family members can offer valuable support at a time when you may be feeling uncertain about your future and scared about your health.

They can help you cope with your feelings when you find out you have hepatitis C.

They can help you deal with the physical and mental challenges of treatment and can support you if you are discriminated against because you have hepatitis C.

There are lots of issues around disclosure and Hepatitis C If you want to talk to someone about your situation

Hepatitis C Resource Centre’s

Telecom Toll Free 0800 224 372 (NZ Only) number will connect you to your closest centre

If you feel you have been discriminated against in a Healthcare setting one option is to talk to the friendly staff at the Health and Disability Commission (New Zealand) who promote the rights and responsibilities of consumers and providers and to resolve complaints Phone 0800 555 050 (New Zealand only)

Another great resource is Living with Hepatitis C in New Zealand Narratives of Chaos and Quest by Magdalena Harris which discusses disclosure and many other issues facing peopl with Hepatitis C in New Zealand

http://www.hcv.org.nz/magindex.html

A fantastic Australian resource is MY CHOICE TO TELL : DISCLOSURE INFORMATION FOR PEOPLE WITH HEPATITIS C produced by Hepatitis Australia Publications, available from their website http://www.hepatitisaustralia.com/resources/publications.html

and discusses many issues including

Do I Have to Disclose?

Disclosing to Friends and Family

Disclosure and Children

Disclosing at Work

Disclosing to Health Care Workers

Best of Health

www.hcv.co.nz

 

Powered by WordPress