Australia needs to increase testing to achieve hepatitis C elimination.

Area of Science:

• Hepatology and infectious diseases.
• Public health and epidemiology.
• Health policy and management.

Background:

• Direct-acting antiviral (DAA) treatments for hepatitis C have been available in Australia since 2016.
• The World Health Organization (WHO) has set targets for hepatitis C elimination by 2030.

Purpose of the Study:

• To evaluate Australia's progress towards the WHO hepatitis C elimination targets.
• To assess the impact of DAAs on hepatitis C testing and treatment rates.
• To project future hepatitis C incidence and treatment coverage.

Main Methods:

• Analysis of Australian government-subsidised hepatitis C RNA testing and treatment data (January 2013 - June 2018).
• Utilisation of an autoregressive integrated moving average (ARIMA) model to assess changes associated with DAA availability.
• Employing a mathematical model to estimate the impact of testing and treatment levels on 2030 elimination targets.

Main Results:

• Hepatitis C treatments increased significantly post-DAA introduction (from 6747 annually to 28,022 annually).
• Diagnostic RNA testing also increased (from 17,385 annually to 23,819 annually).
• Current trends project a 59% reduction in hepatitis C incidence by 2030, falling short of the WHO's 80% target. Increased testing by 50% is needed.

Conclusions:

• Australia's current trajectory is insufficient to meet WHO hepatitis C elimination goals by 2030.
• Increased identification and testing of individuals exposed to hepatitis C are crucial.
• Focusing on enhanced testing rates and improved linkage to care is essential for sustained treatment levels.