Primary Sense Lunch & Learn - Hepatitis C Report

Stalling Momentum in Hepatitis C Elimination

Australia committed to eliminating hepatitis C as a public health threat by 2030, aligning with World Health Organization targets. This means reducing incidence by 80%, mortality by 65%, and achieving high diagnosis and treatment coverage. The Sixth National Hepatitis C Strategy 2023–2030 sets interim 2025 goals, including a 60% incidence reduction from 2015 baselines.

Progress surged after 2016 when direct-acting antivirals (DAAs) were listed on the Pharmaceutical Benefits Scheme, offering cure rates over 95% in 8–12 week oral courses. Over 100,000 people were treated in the first few years, driving down new infections and hepatitis C-related liver transplants. But momentum has slowed. Annual treatment initiations dropped from tens of thousands in the late 2010s to about 5,200 in 2024, with similar trends in 2025 data.

Notifications continue to decline—7,602 in 2023—but remain above levels needed for elimination. An estimated 63,000–69,000 people live with chronic infection, concentrated in groups like people who inject drugs, prisoners, and Aboriginal and Torres Strait Islander communities where prevalence and notification rates are disproportionately high.

Primary care plays a growing role as specialist-led models give way to decentralised care in general practice. Tools like the Primary Sense Hepatitis C Report, funded by ASHM Health and rolled out in late 2025, help practices identify diagnosed patients, those at risk of reinfection, and monitor tests and treatments using metrics such as APRI scores for liver fibrosis.

Non-obvious tensions include declining treatment uptake despite universal PBS access and low costs (often $20 with concessions). Stigma and discrimination affect 71% of people living with the virus, deterring testing and care. Post-COVID drops in sentinel surveillance among injecting drug users signal reduced outreach. Active follow-up of notifications proves cost-effective—$3,500 per QALY gained in pilots—but is not yet widespread.

Risks of inaction are concrete: untreated chronic infection leads to 500+ annual deaths, rising liver cancer burden, and healthcare costs from advanced disease. With only five years left, gaps in testing (around 50% in key populations) and retreatment for reinfection threaten the target.