Brisbane image by Christolakis

The 6th Australasian Viral Hepatitis Conference highlights and comments : Brisbane October 2008

This year there was a strong emphasis on hepatitis B, and the urgent call for a National Hepatitis B Strategy rang clearly across the three day meeting.

“almost 500 delegates ensured that this meeting was terrific event. “

“The conference was held back to back with the Australian Gastroenterology Week
meeting, which meant a good attendance of specialists.”

“The conference had a mix of epidemiology, community responses and
research and basic science. “

“It was a pretty dry conference with rather too much clinical stuff and little, it
appeared to me, of relevance to the situation in NZ. “

“It was a great conference though for catching up with lots of people – and I felt really
wiped out for a good few days afterwards. “

“well catered “

“great opportunity to catch up and share experiences”

Some key presentations

During the opening plenary, Stephen Locarnini, Head, Research and Molecular Development, Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia

gave a hypothetical scoop on how the media would respond if hep B were discovered in 2008: headlines like

“Killer Disease Impacts on 250 Million Globally” and
“2 Million Dead Every Year” —

A far cry from where things really are in 2008.  Mr Locarnini also suggested that one of the biggest barriers to
managing hepatitis B in Australia is, ironically, our reliance on the vaccination.
Jacqui Richmond spoke on her qualitative research, due to be released in May 2009. Some of her points of interest were:

• 85% of respondents preferred face-to-face peer support
• Peer educators required proactive training in the communication of Hepatitis C, as personal stories were not always representative
• More education now leads to less stigma later
• Fear, stigma and discrimination prevented people living with Hepatitis C from accessing treatment
• 62% of the patients in the study diagnosed by their GP; of which only 49% were referred to a liver clinic for treatment
• 50% of the respondents identified GPs as the worst providers of Hepatitis C information but 50% said GPs gave the best physical support.

Jacqui’s paper is to be published in May 2009.

Max Hopwood from the National Centre in HIV Social Research reported data from his qualitative research on ‘Post treatment outcomes’.Major themes of the study showed that clearing the infection minimized future illness, released people from stigma and improved quality of life.

However, there are potential long-term complications arising from treatment. Interview participants reported a variety of sustained physical and psychological after-effects from the Hepatitis C treatment. No end-of-treatment advice being given and treatment ending abruptly were both documented as problems. Participants also reported difficulty in coping with treatment after-effects, with a substantially reduced end-of-treatment quality of life. Some of the problems identified included cognitive difficulties, persistent neurotoxicity and immune system disorders.

Non-responders to Hepatitis C treatment reportedly mourn the loss of their future, the ‘loss of future memory’. Further, there is also the fear for their future health from hearing other people’s horror stories.

Alcohol use and Hepatitis C Everyday resistances: Safe to drink? Alcohol use and hepatitis C. Magdalena Harris, Fantastic peer presentation on the perspectives and peer experiences of alcohol and Hepatitis C

Matthews GV – Frequency of Rapid Virological Response and Its Utility as a Predictor of Treatment Outcome in Individuals Treated within the Australian Trial in Acute Hepatitis C (ATAHC) Rapid virological response (RVR) early in hep C treatment was widely shown to be a strong predictor of SVR (Sustained Virological Response, or cure).  This has implications for greater predictability of treatment success

A number of presentations strongly challenged the notion that all current drug users were inappropriate for hep C treatment, demonstrating that with appropriate support and screening, their success rate was comparable to any other group accessing treatment.

Prof Greg Dore reminded us that while there appears to have been a reduction in the notifications among 15-19 year olds (and evidence that testing patterns have stayed the same), the incidence of hep C in young
women under 20 has doubled.

More evidence was presented to remind us that hep C superinfection (or being infected with more than one genotype or strain of hep C) can and does happen to a significant proportion of people that have had multiple
exposures to hepatitis C.

Presentation – Tina Cooper

Supply and Demand: Strategies to Increase the Liver Donor Pool the paper talking about the need for more people to register as donors, held on the last day,
Presentation – Professor Ian Gust What if: Implementing a National Vaccination Program for HCV – Lessons Learnt from Other Strategies how close we are to having a working vaccine for HCV (also on the last day)
Keynote Speaker – Professor Ed Gane Issues with Liver Transplantation for Hepatitis C

Ed Gane’s talk of Liver Transplantation (especially how a liver will become HCV+ if given to an HCV+ patient)

…………………………………………………………………………………………………………………..

You can find a copy of  Alcohol use and Hepatitis C Everyday resistances: Safe to drink? Alcohol use and hepatitis C. Magdalena Harris, here

Thanks to the Daily Dose The World’s leading drug and alcohol news service for linking to this article about the issues we all face with our drinking choices and hepatitis C.  I highly recommend this daily dose of news.

Thanks to those who contributed info on conference additional feedback from conference attendees welcome email us your comments recommendations admin@hcv.org.nz or leave a comment below.

Its been a long week, im off to have my Roferon injection

best of health

www.hcv.org.nz