Full steam ahead in HCV eradication

A report back on Kerrin Param's session All stories matter in HCV elimination.

Since DAA Hep C treatment was made available on the PBS in 2016, we have seen increases in coordinated MDT efforts. The hepatology partnership model is one of those initiatives. They established community-based clinics in the areas of Caloundra to Bundaberg and in Maryborough prison. By establishing these community-based clinics, they broke down barriers and made Hep C treatment accessible and available to locals within those communities. 

The self-referral strategy resonated well with me. Based on my nursing experience in prison, people who have had an overall stigma-free positive Hep C treatment experience, shares with others. This sharing of experience encourages self-referral, ultimately increasing treatment uptake. I was unsurprised with the difficulty the hepatology team experienced with the workplace culture in prison. This was a big barrier I experienced before. Having a Hep C lead-nurse inside prison who is dedicated to providing non-judgemental care to inmates, will increase treatment uptake and treatment success rate. The prison is likened to a big reservoir of HCV. More should be done to lessen the impact this disease could bring to communities.  So long as the service listens to feedback and continues to seek novel approaches, I am positive that change is not a far possibility. The low confidence of GPs to treat Hep C in the community surprised me. However, being aware that this barrier exists is positive for the service. This awareness should be optimised to think outside the box and look at new strategies.

The next challenge is achieving treatment targets and maximising benefits to these communities. Accessibility and availability alone do not guarantee success. Listening to all stories – feedback from different stakeholders – is key to service improvement. Listening to all stories is catalytic to changes. Listening is key to going full steam ahead.

Author bio: I am a Clinical Nurse previously working at Lotus Glen Corrections, maintaining the Hepatitis C portfolio. Utilising the nurse-led model of care along with coordinated efforts from Cairns Sexual Health Team & Cairns  Liver Clinic, we achieved near-elimination of Hep C in prison giving Lotus Glen the accolade as the first prison in Australia to eliminate Hep C. I am co-author of the article: “Demonstration of Near-Elimination of Hepatitis C Virus Among a Prison Population: The Lotus Glen Correctional Centre Hepatitis C Treatment Project” published in 2018 on the Oxford Clinical Infectious Disease journal.