Hepatitis C New Zealand

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

August 8, 2009

Strategic Directions for Hepatitis C, New Zealand report HCTAG

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , — admin @ 4:45 pm

Strategic Directions for Hepatitis C,

improving access to and uptake of hepatitis C treatment services.

HCTAG Hepatitis C Treatment Advisory Group , NZ ministry of health

Thanks to NZ minister of health Hon Tony Ryall for releasing this draft copy

A few points that I found interesting the context for HCV Planning

The 50,000 figure with 1300 new infections per year, and we are treating around 600

“unless annual numbers of HCV positive New Zealanders receiving anti viral therapy  were to increase by % 300”

This would put the treatment numbers ahead of the new infections. At the moment we are going backwards every year with less treated than catching hepatitis C.

The current numbers are a joke, a token effort from The Ministry of health they are doing something just nowhere near enough to make an impact on the epidemic.

The pool of infected is growing every year, I could wear myself saying this, but fortunately this report lays it all out, in a much more logical manner then me.

Will anything change  ? NO .

The Ministry of health  are growing a massive public health disaster and there poor quality decision making and public health policy is growing the epidemic and future heath costs

Other recommendations

Key action areas increasing diagnosis

Key action area 3: Increasing the percentage of all people with HCV who have had the disease diagnosed

Key facts

An estimated 75 percent of the New Zealand population with HCV are unaware that they have the disease.

The major barriers to treatment in New Zealand with HCV infection are that people are unaware of their infection, or that the diagnosis is delayed until the liver disease is advanced, by, which time treatment is less effective. Because most people with HCV infection feel well or only have non-specific symptoms, early diagnosis requires targeted testing of all people who are at risk of previous exposure to HCV

• The largest undiagnosed pool of people with HCV are likely to be those aged 40-60 years old, who were infected 25-40 years ago, who at that time occasionally or even  once) injected illicit drugs, but went on to lead ‘conventional  Iives’.

This report should have been released months ago and the country can’t afford to wait to implement improvements. Absolute BS that it doesn’t in clued a implementation plan.

Its’ another reasonable report onHepatitis c in New Zealand it is a shame it will never be acted on and people will die and they will die increasingly in large numbers and they will die utterly preventable deaths. unless there is a significant increase in testing, diagnosis and treatment the number of people with end-stage liver disease – that is decompensated cirrhosis and liver cancer – will continue to increase . We are looking at: unnecessary death.

Draft copy released under OIA 29 July 09

http://www.hcv.org.nz/hepatitiscstrategynz.pdf (3 mgb file)

Meanwhile in England Hepatitis C out of control

undiagnosed; too few of those diagnosed are receiving the recommended treatment; and there are worrying regional variations in hepatitis C healthcare and delivery of treatment across the country. Of particular concern is the number of new infections each year – more than five times the number of people being successfully treated – indicating that prevention methods are not working. Clearly, the management of hepatitis C is out of control.

http://www.hepcoutofcontrol.org.uk/home.html

Hepatitis C is not slowing down in New Zealand it’s growing exponentially

RECENT TRENDS IN ILLEGAL DRUG USE IN NEW ZEALAND, 2006

a frightening reality vividly evident in this report

http://www.ndp.govt.nz/moh.nsf/pagescm/1109/$File/idms-2006-final-report-v2.pdf

“Forty-six percent of the frequent drug users had used injection equipment

after someone else in the past six months”

15.7 Summary of injecting behaviour

Forty-six percent of the frequent drug users had used injection equipment after someone else in

the past six months

Thirty-five percent of the frequent drug users had not always used a new sterile needle and

syringe when injecting drugs in the previous six months

The prevention effort of needle exchanges may have slowed the epidemic but even that seems questionable with behavior like above, the ongoing failure to address the problem is costing New Zealand dearly and is going to continue unless something is done.

Increase prevention efforts audit needle exchanges to optimise their services.

Anonymous community pharmacy blood testing for hep C  to try and reach the %75 of New Zealanders who are undiagnosed.

Show some leadership Ministry of Health and follow through invest in testing diagnosis and treatment.

best of health

www.hcv.org.nz

May 18, 2009

New Zealand Hepatitis C, World Hepatitis Day Are you the 1 in 12?

Filed under: Hepatitis C New Zealand — Tags: , , , , , , , , , , , , — admin @ 5:53 pm

New Zealand Hepatitis C, World Hepatitis Day

Are you the 1 in 12?

World Hepatitis Day Tuesday May 19 2009 .

Apologies  to the New Zealand Hepatitis Foundation , Thanks for the update John  ”

Hepatitis Foundation of New Zealand

“On your blog page dated 18 May 2009 you stated that “here in New Zealand the Hepatitis Foundation has been in charge of world hepatitis day publicity this year”. You also go onto say that you pretty much missed the ads on TV.

For clarification the Hepatitis Foundation of New Zealand has not been in charge of publicity in NZ for World Hepatitis Day. We as a an organisation have not been in contact with any other organisation nor have we collaborated with publicity. The ad you are referring to on Prime TV is the responsibility and sanctioned by Bill Jang, Hep C Support Group. The Foundation sent out a media release as you  are aware of and the poster, no ads on TV.

Therefore i would appreciate that you retract this statement from your blog site and print the correct information.

Best wishes

John Hornell
Chief Executive Officer
Hepatitis Foundation of New Zealand  ”

publicity this year.

Hepatitis C Treatment in  New  Zealand Survey

Waiting for a complete set of replies from all DHB’s District Health boards before posting them all up, hopefully early June should have them online.

Biopsy for Hepatitis C in New Zealand ?

To clarify from the last blog post about Biopsy for Hepatitis C in New Zealand.

“I missed the news but apparently it is no longer mandatory to have a liver biopsy before treatment can be accessed. I will try and confirm this but that is what we were told.”

Had some great feedback on this which I have made anonymous as I’m unsure if it was to be attributed or not? Thanks for the feedback.
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.

I suggest that individuals talk to their GP or Specialist to see if they would require a biopsy before treatment.

I hope that clarifies things! ”

Talk to your Health professional if you have concerns and remember they are there to look after your health and have your best interests at heart.
A liver biopsy can give valuable information regarding staging, prognosis, and management of Hepatitis C.
In New Zealand to access treatment for Hepatitis C mostly you will have to have a biopsy,

“It took me years to work up the courage to have one, It was not as bad as I had expected at all.”
A biopsy revels the extent of liver fibrosis which also may determine your priority for treatment in some DHB’s in New Zealand.

Community Pharmacies Testing for Hepatitis C and B

This is my favorite World Hepatitis Day activity from England

“A pilot project developed by The Hepatitis C Trust will see pharmacies in five PCTs across England offering free, on-demand dry blood spot testing for the potentially fatal viruses.

Pharmacists in 19 participating stores have been trained to carry out the tests and give patients lab results. If positive, patients will be referred to their GPs for treatment.

The Hepatitis C Trust hopes the confidential yet accessible community pharmacy setting will persuade hundreds of thousands of potentially undiagnosed hepatitis sufferers in England to come forward for testing”

what a brilliant idea to uncover the hidden burden of hepatitis c in our communities.

Be great to see Community pharmacies offer this service in New Zealand

Hepatitis C: The silent killer among us

Article from Press newspaper Hepatitis C: The silent killer amongst us.

“Hepatitis C’s stigma as a “junkie disease” could be preventing thousands of New Zealanders from getting potentially life-saving treatment.

About 50,000 New Zealanders are infected with hepatitis C, with many infected through unscreened blood transfusions, experimentation with intravenous drugs or by just using a flatmate’s razor.”

How long hepatitis C could survive in syringes ?

A description of the experiments done at Yale university to find out how long hepatitis C could survive in syringes. Also a good explanation of why Hepatitis C is so infectious.

Was sitting in Lab getting my blood tests today  and listening to the blood gurgle out of me and fill the vacuum tube, listening because I never look. thinking how much I hate blood tests and hopefully this might be my last one for a while.

Here is hoping…….

Best of health

www.hcv.org.nz

August 17, 2008

How educated about Hepatitis C are New Zealand Gp’s ?

Filed under: Hepatitis C New Zealand — Tags: , , , , , , — admin @ 1:20 pm

When you talk to other people with Hepatitis C there is always a wide discussion on how well informed GP’s are about the disease its’ effects and treatment.

Magdalena Harris, thesis, Narratives of Chaos and Quest, Living with Hepatitis C in New Zealand, has a great Chapter Six: The Medical Encounter which contains examples of this interaction. see http://www.hcv.org.nz/magchapt6.html

In my experience GP’s knowledge is variable and it is a good idea to seek out a knowledgeable Doctor, Like everyone GP’s are not all the same or equal, Which is why I found a recent english survey so interesting and wondered how much it reflected the New Zealand experience.

From the excellent English web site http://www.hepctrust.org.uk/

”

Over one-third of GPs “failing to diagnose Hep C”

A survey has revealed that more than one third of doctors in general practice are unable to read their patients’ hepatitis C results.

This figure is exacerbated by a failure to follow up with patients even when they have been correctly interpreted, according to a survey of 200 GPs by ICM Healthcare on behalf of The Hepatitis C Trust.

Some people who contract the disease suffer mild to more serious symptoms but one in five will clear the virus naturally. In about 20% of cases cirrhosis of the liver will develop over a period of 20 years or more.

Almost a third of GPs (32%) do not actively follow up with patients who test positive for hepatitis C and more than two-thirds (77%) said they did not consider infectious diseases to be a major threat to public health.

Charles Gore, chief executive of The Hepatitis C Trust, said: “GPs must take some responsibility to ensure patients with hepatitis C are not left undiagnosed.

“More must be done to equip GPs with the right information so they can correctly identify those who should be offered a hepatitis C test and interpret any result correctly.”

The poll was funded by pharmaceutical company Roche. ”

Best of Health

www.hcv.org.nz

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