The advent of highly effective direct-acting antiviral therapies for the treatment of the Hepatitis C Virus (HCV) means that elimination is now firmly on the agenda, with the World Health Organization recently announcing elimination targets including:

• A 65 percent reduction in HCV-related deaths by the year 2030
• An 80 percent reduction in HCV incidence by the year 2030.

Image: HCV related liver disease among current and former PWID in Australia: project outcomes 2015-2030 under different treatment scenarios.

We are aiming to answer the following questions in a range of settings:

• How do we determine the most cost-effective scale-up of treatments among priority groups, through different modalities, and over different time-frames?
• How much will it cost to reach strategic targets?
• How can the cascade of care be optimised to maximise the number of people receiving curative treatment?
• Where are the bottlenecks?
• Which modalities of which programs are required (e.g. mobile clinics or nurse-led models of care)?

Given the limited resources available, we will investigate what the best use of funding across the programs of prevention, testing and treatment might be to:

• Minimise morbidity and mortality
• Minimise new infections
• Get as close as possible to multiple national targets.

Timeline

2015-ongoing.

Publications

2017

• Reaching hepatitis C virus elimination targets requires health system interventions to enhance the care cascade.
  Scott N, Doyle JS, Wilson DP, Wade A, Howell J, Pedrana A, Thompson A, Hellard ME
  Int J Drug Policy. 2017 Sep; 47:107-116
• Treatment scale-up to achieve global HCV incidence and mortality elimination targets: a cost-effectiveness model.
  Scott N, McBryde ES, Thompson A, Doyle JS, Hellard ME
  Gut. 2017 Mar; 66(8):1507-1515
• Limited provision of diagnostic services to Victorians living with hepatitis C antibodies, 2001-2012: a multi-level modelling analysis.
  Snow K, Scott N, Clothier HJ, MacLachlan JH, Cowie B
  Aust N Z J Public Health. 2017 Feb; 41(2):193-198

2016

• The Potential Impact of a Hepatitis C Vaccine for People Who Inject Drugs: Is a Vaccine Needed in the Age of Direct-Acting Antivirals?
  Stone J, Martin NK, Hickman M, Hellard M, Scott N, McBryde E, Drummer H, Vickerman P
  PLoS One. 2016 May; 11(5):e0156213
• Cost-effectiveness of treating chronic hepatitis C virus with direct-acting antivirals in people who inject drugs in Australia.
  Scott N, Iser D, Thompson A, Doyle J, Hellard M
  J Gastroenterol Hepatol. 2016 Feb; 31(4):872-882
• Modelling hepatitis C virus transmission among people who inject drugs: assumptions, limitations and future challenges.
  Scott N, Hellard M, McBryde E
  Virulence. 2016 Feb; 7(2):201-208

2015

• The role of a hepatitis C virus vaccine: modelling the benefits alongside direct-acting antiviral treatments.
  Scott N, McBryde E, Vickerman P, Martin NK, Stone J, Drummer H, Hellard M
  BMC Med. 2015 Aug; 13:198