EC Victoria is led by Burnet Institute in partnership with St Vincent’s Hospital Melbourne and key stakeholders across the hepatitis C (HCV) elimination sector. The partnership aims to increase HCV treatments to 1,160 people who inject drugs a year (PWID), for five years. The results of this project will be used to measure the impact of treatments on the prevalence and incidence of HCV in Victoria and inform HCV elimination models in Australia and globally.

EC Victoria achievements

• EC Victoria supported 11 primary care services to test 4,473 and treat 1,162 people.
• Across 14 prison sites, EC Victoria supported the assessment of 2,465 and treatment of 1,928 people.

Further funding:

• EC Victoria informed the design of the Eliminate Hepatitis C Australia Partnership, an $11.3 million philanthropic grant (Paul Ramsay Foundation).
• RapidEC informed the NHMRC Grant ($1,459,971) and Gilead Grant ($1,062,026) for the National Quickstart Trial and the CT2 Myanmar Project.
• PATH pilot led to funding for PATH EX-panded through Gilead Grants ($171,248.31).
• St Vincent’s Hospital Melbourne secured funding for 12 months to establish partnerships with MSIR, Community Corrections and the IHN Network to pilot new models of care for testing and linkage to treatment.
• EC Victoria’s work led to a successful NHMRC Program Grant on ‘The elimination of Hepatitis C as a global public health threat’ ($7,001,475).

EC Victoria provided support to communities and health services through six components:

1. Health Promotion
2. Training and Education
3. Clinical Support
4. Data Systems and Surveillance
5. Research and Evaluation
6. Prison Program

1. Health Promotion

• Funded partners to develop new health promotion resources for PWID
• Hepatitis Victoria: ‘Be free from C – Getting treated on the outside’ and updated fitpack stickers
• Harm Reduction Victoria: ezy-card resources
• Convened an EC Health Promotion Working Group that met regularly to share information and project lessons, and develop a catalogue of HCV resources available in Victoria.
• Improved resources to increase client health literacy

2. Training and Education

• Provided clinical HCV information to GPs through the HepCHelp website, which was later superseded by HCV Consensus Guidelines.
• Trained and mentored individual providers at EC sites.
• Developed a FibroScan Training and Certification Program and loaning agreement for Integrated Hepatitis C Nurses in regional Victoria.
• Produced resources for clinicians to understand HCV treatment requirements and streamline pathways to further liver fibrosis assessment and post-treatment monitoring.
• Delivered HCV training sessions for primary care nurses and people working in alcohol and drug settings, together with the Victorian HIV and Hepatitis Integrated training and learning program, primary health networks and ASHM.

3. Clinical Support

• Informed the EC Model of Care through identifying gaps and opportunities found in a scoping exercise across 18 clinics with a high caseload of PWID, and 12 Integrated Hepatitis C Nurses.
• Developed and disseminated the EC Practice Support Toolkit to over 600 primary care providers. This comprehensive resource included: support resources for patients and providers, and health service management.
• EC Nurses provided services at EC sites including on-site pathology, fibroscans, treatment assessments, referrals and support to service staff to recall and follow up clients.
• Trialled the use of a vein finder as a tool to support clinicians.

4. Data Systems and Surveillance

• Expanded the ACCESS surveillance system to include 16 primary care sites.
• Developed indicators to monitor the HCV care cascade.

5. Research and Evaluation

• Conducted a pilot study of Rapid EC, a rapid point-of-care test to demonstrate the value of these tests in reducing barriers to testing.
• Identified enablers and barriers to accessing treatment through the longitudinal study of PWID, EC Experience Cohort.
• Conducted the pilot project, Peer Assisting Treatment of Hepatitis C (PATH), together with Harm Reduction Victoria, Access Health and Salvation Army.
• Conducted a mapping of different populations to engage in HCV care. This led an ongoing systematic review of barriers and enablers to HCV care.
• Delivered a hepatitis C testing campaign during World Hepatitis Day in July 2019.

6. Prison Program

• Developed a statewide program on viral hepatitis assessment and treatment in prisons. This included quality improvement and evaluation through a dedicated evaluation and research coordinator.
• Conducted a trial to evaluate the effectiveness of a care navigator to link people released from prison into community-based hepatitis C care.
• Established an annual reporting of hepatitis C treatment numbers among prisoners for the report, Australia’s progress towards hepatitis C elimination.
• Contributed to the development of a national consensus statement on the management of hepatitis C in Australia’s prisons.