Trial of new hepatitis care model aims to raise cure rates

Dr Joseph Doyle

by Anne Crawford

130,000 people live with untreated hepatitis C (HCV) in Australia. Direct-acting antiviral treatment marked a new era in HCV treatment and has the potential to eliminate the disease as a public health threat. But although curative treatment, which targets specific steps within the hepatitis life-cycle, has been available as a PBS-funded therapy in Australia for nearly three years, the number of people commencing it is falling.

In particular, people who inject drugs (PWID), who have the highest burden of hepatitis, can be difficult to engage in traditional models of care. It currently takes several visits to doctors to test, confirm, and start people on curative HCV treatment.

Dr Joseph Doyle from the Department of Infectious Diseases has received a $1.459 million Clinical Trials and Cohort Studies grant from the National Health and Medical Research Council to conduct a paradigm-changing trial assessing the clinical and cost-effectiveness of a same-visit HCV testing and treatment model of care for PWID.

The QuickStart Study will use a cluster randomised controlled trial design to evaluate the impact of rapid testing and treatment provision on hepatitis cure. The hypothesis is that a same-day test and treatment model of care will significantly enhance hepatitis cure among PWID, and be cost-effective in real-world settings.

“Surveillance data and modelling shows us that health-care providers are not testing and re-testing often enough to engage people in care. This makes it harder and more expensive to reach our HCV elimination targets. It also leaves many people living with a curable infection because they are not linked to health care,” Dr Doyle said.

“A same-visit service would simplify care, lead to more people starting treatment, and more people will be cured. It may also be highly cost-effective and help implement Australia’s national hepatitis C strategy,” he said.