Estimating the number of new hepatitis C infections in Australia in 2015, prior to the scale-up of direct-acting antiviral treatment.

Anna Y Palmer, Anna Wilkinson, Campbell Aitken, Paul Dietze, Gregory J Dore, Lisa Maher, Rachel Sacks-Davis, Mark Stoove, David Wilson, Margaret Hellard, Nick Scott

Journal: Journal of gastroenterology and hepatology 2022;36(8):2270-2274

PMID: 33691343

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Abstract

BACKGROUND AND AIM

The recent downward revision of the estimated number of people living with chronic hepatitis C in Australia means that the annual number of new hepatitis C infections should also be revised. We aimed to estimate the annual number of new hepatitis C infections among people who inject drugs (PWID) in Australia in 2015, prior to the introduction of direct-acting antiviral (DAA) treatment for hepatitis C, as an updated baseline measure for assessing the impact of DAAs on hepatitis C incidence over the next 10 years.

METHODS

A systematic review identified articles estimating hepatitis C incidence rates among PWID between 2002 and 2015. Reported incidence rates were adjusted to account for unrepresentative needle and syringe program (NSP) coverage among study participants compared with PWID overall. The total number of PWID in Australia and the hepatitis C RNA prevalence among PWID were taken from published estimates. The annual number of new infections was estimated by multiplying the pooled NSP coverage-adjusted incidence rate by the number of susceptible PWID in 2015.

RESULTS

Five studies were included, with unadjusted incidence rates ranging from 7.6 to 12.8 per 100 person-years. The overall pooled incidence rate (after adjusting for NSP coverage) was 9.9 per 100 person-years (95% confidence interval: 8.3-11.8). This led to an estimate of 4126 (range 2499-6405) new hepatitis C infections in 2015.

CONCLUSIONS

Our updated estimate provides an important baseline for evaluating the impact of hepatitis C elimination efforts and can be used to validate outcomes of future modeling studies.

Address: Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia.; Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.; Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.; Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia.; Peter Doherty Institute for Infection and Immunity, Parkville, Victoria, Australia.; School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.

DOI: 10.1111/jgh.15485

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MeSH Terms: Antiviral Agents, Hepacivirus, Hepatitis C, Hepatitis C, Chronic, Humans, Substance Abuse, Intravenous