Hepatitis C New Zealand

July 23, 2010

100% Pure New Zealand Hepatitis C

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

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

May 25, 2009

Increasing Access to Hepatitis C Treatment in New Zealand

New Zealand Ministry Of Health Stock take of Existing Services May 2007 May 2008

“often with additional commentary” for Sara and Sue

The Minister of Health finally released a copy of  a stock take of hepatitis C services in New Zealand. My copy is the appendix of the new Hepatitis Plan to be released by the Ministry soon.

It covers a lot of the detail of Hepatitis C Treatment around New Zealand, it really is a lottery of care with some regions winners and others losers in the level of treatment available.

you can download a pdf  file of the report here  stock take of hepatitis C services

It answers questions

Referral

1. What are your guidelines for referral to secondary care for patients with hepatitis C?

2. Do you add any information to seek prioritisation?

3. What is on the referral form? Is there routinely provided an adequate history including recent LFTs, risk factors for HCV exposure, duration of infection, alcohol intake, how
long clean from IDU, etc?

4. Where are the referrals sent from primary care (Central Bookings Office, specific departments or individuals)? Who is responsible for sorting these? Who proritise referrals?

5. Which speciality units in your hospital will provide outpatient assessment and treatment for patients with hepatitis C: General Medicine, Infectious Diseases, Hepatology, Gastroenterology?

6. How are hepatitis C patients prioritised relative to other patients within the specialty and what are the factors used to prioritise hepatitis C patients (eg, acute hepatitis C,
probably cirrhosis, hepatoma, immunosuppressed, etc)?

7. What is the GP’s role in the process after referral?

8. How many referrals are returned to the GP due to low priority? What determines such “Iow priority” status?

9. Are patient referrals confirmed prior to the clinic day — by letter, phone?

10. What is the non-attendance (DNA) rate and what is the process following a DNA? How many times will DNA patients be rebooked? If DNA patients are discharged, are
they referred back to their GPs?

11. lf patients are not suitable candidates for treatment, refuse treatment or have undergone treatment but failed, are they discharged back to the GP?

Post-first assessment

12. Who conducts the initial new-patient assessment- specialist, registrar, house-surgeon or nurse? ls every clinic supervised by a specialist?

13. What tests are ordered at this initial assessment: LFTs, HCV-RNA, viral load, viralgenotype, ultrasound, liver biopsy?

14. How is the severity of liver disease assessed in people with bleeding disorders prior to treatment- biopsy (transjugular vs percutaneous), ultrasound, scintography, other?

15. What is done to prepare patients for antiviral therapy: What various activities happen between new-patient specialist assessment and commencing treatment:

16. ls a psychiatric assessment performed routinely on all patients prior to the decision on therapy? How is this done — subjective assessment? Objective score (eg, HADS
score)? Formal liaison psychiatry review?

17. Do patients receive information in preparation for treatment (re side effects, etc)? If so,what information and in what form? For example, clinic visits, written information, etc.

18. What testing do you do after first assessment? ie, genotype? viral load? biopsy?

19. What are the exclusion criteria for treatment: alcohol abuse/length of abstinence; injecting drug use; length of abstinence; methadone; cannabis; other?

Treatment

20. ls there a standard treatment protocol for hepatitis C that you follow?

21. In patients infected with HCV genotype 1 do you follow the “earIy stopping rule” for treatment, ie, if HCV-RNA level after 12 weeks has not dropped by more than two logs
from baseline level, is treatment stopped?

22. ln patients infected with HCV genotype 2 or 3, how many weeks treatment is administered?

General statistics

23. What is the total number of first time specialist appointments for patients with hepatitis C at your hospital annually?

24a. How many patients with diagnosed hepatitis C were referred to your unit in 2005/2006?

24b. How many patients with diagnosed hepatitis C were referred to your unit in 2004/2005?

25. What is the total number of patients [with hepatitis C] treated at your hospital annually?

26. How many patients are CURRENTLY on treatment for hepatitis C at your hospital?

27. What is the total number of follow ups, including nurse and physician appointments seen at your hospital annually?

28. How many patients with chronic hepatitis C were seen at your hospital between 1 January and 31 December 2006? Between 1 January and 31 December 2005?

Waiting times

29. lf someone with hepatitis C is referred this week from their GP, what is the approximate waiting time for an initial specialist assessment at your hospital?

30. What was the total number of patients with hepatitis C waiting for initial assessment as at 1 July 2006?

31. How many new hepatitis C patients were added to the waiting list in the last six month period?

32. What is the approximate time interval between receipt of initial referral from GP, to first time specialist appointment, to commencement of antiviral therapy?-

33. What are the factors that contribute to waiting times?

Other

34. What limits capacity?

35. Do you have a dedicated hepatitis clinic?

36. How many FTE nurses and physicians are allocated to hepatitis C treatment at your hospital?

37. Do you have online access to GPs’ laboratory results?

38. Do you make your laboratory results available o-line to GPs?

download the full report here

Looking forward to the answers to these regional health inequalities in the Hepatitis Plan to be released soon

Happy Birthday to the needle exchange in New Zealand 21 years old this year

Approximately 200 outlets around New Zealand provide new needles to injecting drug users and safely dispose of used needles. Around 3 million clean needles are distributed each year with many outlets also providing information and advice about preventing the transmission of blood-borne diseases and drug treatment options.

national manager of Needle Exchange New Zealand, Charles Henderson.

Speaking at an event on Tuesday to mark the 21st birthday of needle exchanges in this country, Mr Henderson said that, thanks to the programme, New Zealand has a lower HIV rate amongst its intravenous drug users than any other country, and that the spread of hepatitis B amongst injecting users has largely been contained.

“We’ve got the prevalence of HIV/AIDS down to just 0.3% and studies indicate there have been no new AIDS or hepatitis B infections within this group in recent years. This is quite remarkable considering blood-borne diseases are often rife amongst drug-using communities where needle-sharing is commonplace.

“It’s wonderful news for New Zealand as a whole because carriers of blood-borne diseases interact with others in their communities and can spread these diseases to people who don’t inject drugs.

“Over the last 21 years, the Needle Exchange Programme has saved thousands of Kiwi lives and millions of tax-payer dollars.”

You notice Charles (NENZ ) dos not mention Hepatitis C,  The needle exchange is not effective in stopping the spread of Hepatitis C, It is slowing the spread of Hepatitis C,  But how, can it work better to stop the growth and spread of Hepatitis C ?

The latest Household Drug Survey indicates 2 percent of New Zealand ers  inject or have injected drugs, including opiates and methamphetamine, in the last 12 months. This means 85,000 people are potentially susceptible to blood-borne diseases from drug use.

Estimating New Zealand Hepatitis C Figures By District Health Board Areas

We had a go at calculating the estimated numbers infected by HCV by district health board areas I used a conservative estimate of .8% of population being infected, here is what I calculated using 2007 figures.

DHB populations are approximately: Estimate of 0.8% population HCV
Number with HCV
DHB Population (000s)
Northland 154 1232
Waitemata 516 4128
Auckland 439 3512
Counties Manukau 468 3744
Waikato 355 2840
Bay of Plenty 204 1632
Lakes 102 816
Tairawhiti 45 360
Taranaki 107 856
Hawke’s Bay 153 1224
MidCentral 165 1320
Whanganui 63 504
Hutt 141 1128
Capital & Coast 282 2256
Wairarapa 39 312
Nelson Marlborough 135 1080
West Coast 32 256
Canterbury 491 3928
South Canterbury 55 440
Otago 185 1480
Southland 110 880
Source: Statistics NZ population projections, Sep 2007. 4241 33928

I just wanted to get a idea of the scale of the problem I used similar figures to the Hepatitis C infection in New Zealand: Estimating the current and future prevalence and impact July 2000.

Looking forward to seeing the new Hepatitis C Plan in the next few weeks the Hepatitis C Plan will hopefully address the problem areas from the Stock take report

Topper Headon (Clash)

Topper talks about his year on treatment and how he beat the hepatitis C virus

clean and healthy post hepatitis C treatment , a great short video

Best of Health

www.hcv.org.nz

September 4, 2008

another day another 3.5 New Zealanders infected with hepatitis C

Nothing to eventful happened this week to me any way.

But unfortunately it is predicted another 25 New Zealand people caught hepatitis C http://www.hcv.org.nz/minhealth08HDAY.html

so something eventful did happen in their lives

This is what the virus looks like HCV Virus

it invaded their bodies so silently, They probably don’t know it yet, but the narrative of their lives is starting to change, what’s their future going to be like ?

Will they unknowingly pass the infection on.

The pool of infected, they have fallen in to, already has 45,000 to 50,000 members struggling to stay a float.

It not an exclusive club you can join any where blood is swapped.

What are their chances of being treated, slim today but may be in the future more people will be treated ?

Aware

In Otago the district health board has recently answered some questions about hepatitis C

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

A similar number of people are going to treated in 2009 as 2008 26 people

why so low ?

well we asked them that to

“Treatment delays are primarily related to budget and staff shortages are a secondary reason.”

So it all comes down to budgets money.

This no doubt would be the answer that all 21 District Health Board’s in New Zealand would give, the bottom line money.

competing demands on scarce health dollars.

Why should they invest more in Hepatitis C treatment ?

It saves them money, it costs more in the long term to look after people with advanced liver disease than it does to treat them with interferon.

“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.

http://www.hcv.org.nz/ecocostnz4prt2.html

So whats the plan for the future ?

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. 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.

This advisory group has written a report that will be released soon. ?

We all await it with high expectations of an improvement in the current situation.

But realistically …………………

best of health

www.hcv.org.nz

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