Newsletter Issue 08 | June 2014
Page 08
C the person not the disease livE HEAlTHY
WiTH HEP C Page 14
FREE!
SHANNON’S STORY
Please take one!
p.04
Don’t forget to renew your HepatitisWA Annual Membership! Form inside on page 17.
THE $84,000 HEPATITIS TrEATmENT DrUG
Page 10
GOING VIRAL | CURRENT HEPATITIS C TREATMENTS | WASUA’S HEALTH SERVICE
JUNE 2014
Contents
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10
PERSONAL PERSPECTIVE
COMMUNITY NEWS
WASUA’S DOMAIN
04 Shannon’s Story Twenty-one year old Shannon was
06 Going Viral A round-up of articles on viral
18 WASUA’s Health Service
a heroin addict. After she recovered she discovered she had contracted hepatitis C. This is Shannon’s story.
Features 08 C the person not the disease In the month of July to coincide with World Hepatitis Day (28th July), HepatitisWA will launch the C the person not the disease campaign to help raise awareness of hepatitis C, with a view to increasing access to testing, treatment and care. The campaign is targeted to GPs, allied health professionals, and the general community.
10 Is an $84,000 hepatitis treatment drug too expensive? An $84,000* hepatitis treatment
hepatitis.
Feature by the WA Substance User’s Association (WASUA).
12 Current hepatitis C treatments A snap-shot of current hepatitis C
PROMOTIONS
treatments .
17 HepatitisWA Annual Membership Renewal Form
16 Hepatidings
HepatitisWA Community Activities.
HEALTH & LIFESTYLE 14 Live Healthy with hepatitis C In most cases, hepatitis C is an
illness where changes happen slowly, and a person may not have symptoms for a long time, if ever. This article explores options on how to take control of your health when living with hepatitis C.
Please complete your details on the form on page 17, cut-out and return with membership payment.
20 HepatitisWA Peer Support Group Advertisement
Share experiences and thoughts with peers in a friendly, non-judgmental environment.
drug called Sovaldi is at the center of a new battle between pharmaceutical companies and insurers. *($84,000 US dollars)
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HEPATITISWA Newsletter // June 2014
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LETTER FROM
tHe eDItoR Welcome to the June edition of the HepatitisWA Newsletter! As we are approaching July, to coincide with World Hepatitis Day (28th July), HepatitisWA will launch the C the person not the disease campaign to help raise awareness of hepatitis C, with a view to increasing access to testing, treatment and care. The campaign is targeted to GPs, allied health professionals, and the general community. To show your support, or to learn more about the campaign, hepatitis C, and current treatments, please visit the campaign website at www.ctheperson.com.au. In this issue, we feature an article on the controversial cost of a new hepatitis C treatment drug released in US at $1000 per pill, and an article on the current hepatitis C treatments available in Australia. The personal perspective in this issue is from former heroin-addict, Shannon. Other features include a round-up of viral hepatitis articles in our ‘Going Viral’ section and HepatitisWA’s recent community activities in ‘Hepatidings’. Our health and lifestyle section features an article on healthy living with hepatitis C, and WASUA introduces their new nurse Jo and the services she provides. Please also take note of WASUA Bunbury’s timetable changes for their mobile NSEP.
Felicia Bradley
on tHe CoVeR C The Person Not The Disease PAGE 08
stay
Editor
The cover image is taken from Hepatitis NSW’s campaign C the person not the disease, Jan 2014.
connected www.hepatitiswa.com.au
Newsletter
Editor Felicia Bradley Graphic Artist Felicia Bradley Board of Management Executive Members Chair Dr Susan Carruthers Treasurer Ms Maria Kroon Secretary Ms Lyn Tolliday Non Executive Members Mr Mark Lowery Ms Ursula Swan Ms Max Taylor Dr Aesen Thambiran Executive Director Frank Farmer Postal Address PO Box 67 Francis Street Northbridge, WA 6865 Information & Support Line Monday – Friday | 9am – 5pm (08) 9328 8538 Metro 1800 800 070 Country Office 134 Aberdeen Street Northbridge, WA 6003 Telephone: (08) 9227 9802 Fax: (08) 9227 6545 Web: www.hepatitiswa.com.au Proof Reading Frank Farmer Ms Maria Kroon Email the Editor resources@hepatitiswa.com.au
www.playthebloodrule.com www.facebook.com/HepWA www.twitter.com/HepatitisWA Opinions published in the HepatitisWA Newsletter are not necessarily those of the editor or of HepatitisWA (Inc). Information in this newsletter is not intended to take the place of medical advice from your GP or specialist. You should always get appropriate medical advice on your particular needs or circumstances. *Disclaimer: The copyright of external articles published in this newsletter remain with the original authors and publishers, unless otherwise stated.
HepatitisWA (Inc). HepatitisWA is a community based organisation which provides a range of services to the community in response to viral hepatitis, particularly hepatitis A, B and C. Please contact us for more information, or make an appointment to call by and talk with an appropriate member of our staff.
HEPATITISWA Newsletter // June 2014
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If you are looking to start treatment for hepatitis C, just know that if I can get through it, then so can you.
Source: Article written by Shannon M and originally published on Hepatitis Central. URL: www.tinyurl.com/shannons-story 4 HEPATITISWA Newsletter // June 2014 Image available under a creative commons license at www.photodune.net. Photography by Acidgrey. Š All Rights Reserved Acidgrey. The photography used for this article is for illustrative purposes only and any person depicted therein is a model.
PERSONAL PERSPECTIVE
SHANNON’S STORY
I
TWENTY-ONE AFTER SHE CONTRACTED
YEAR OLD SHANNON GOT CLEAN SHE HEPATITIS C. THIS
WAS A HEROIN ADDICT. DISCOVERED SHE HAD IS SHANNON’S STORY.
am 21 years old, and I have been clean from heroin for a little over a year. When I first got clean, that’s when I discovered that I had the hepatitis C virus (HCV). I was uneducated about the virus. Therefore, I assumed there was no treatment and that I would be infected for the duration of my life, most likely eventually dying from HCV related complications. I made an appointment with a liver specialist, following directions from my PCP, and as I waited for my appointment, I fell into a deep depression. I eventually found out that I had Genotype 1 and that I would be on three different medications: incivek, ribavirin, and an interferon shot. I am in the last month of my treatment (24 weeks). The last two viral loads I had done came up negative. I am told by my doctors that the virus will most likely not come back. I am also told that after the treatment ends, I will continue to get blood work done for the following 6 months. Currently, I feel that I have overcome HCV, and I want other people reading this to know that if I can overcome it, so can you.
I separated myself from the addicts, and my non addict friends wanted nothing to do with me after my diagnosis. I already had been diagnosed with depression and anxiety at a very young age; this treatment made it much worse. I continued seeing my psychiatrist, went to weekly therapist sessions, and I also joined Narcotics Anonymous (NA). If you are a recovering addict who will be undergoing HCV treatment, I cannot express to you how important it is to go to NA. Honestly, to me, it’s not about going there everyday and telling a group of strangers how I feel. For me, it’s finding those people that you can befriend, and they understand you completely, and will not judge you.
This part of my life has been extremely difficult for me. I had to take a medical leave from school and reduce my hours at work. Some days, especially after the shot, I cannot get out of bed. Also, I feel fatigued and lethargic almost 100% of the time. Being at the age I am, and having two different groups of friends, addicts and non addicts, I lost all of them.
If you are looking to start treatment for hepatitis C, just know that if I can get through it (I grew up as a “spoiled” brat whose parents did anything for her), then so can you. This whole experience has changed my life for the better, and honestly, I am starting to be reluctantly happy that it occurred.
Even though I have a month or so of treatment left, I am finally seeing the light at the end of the tunnel. I have overcome drug addiction and HCV. These last four years of my life have made me into a strong person. Non addicts view me as weak, but they do not have the slightest clue what I (or any other recovering addict) has been through.
HEPATITISWA Newsletter // June 2014
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Going VIRAL A round-up of articles on viral hepatitis DEATH FROM VIRAL HEPATITIS SURPASSES HIV/AIDS AS PREVENTABLE
cause of death
D
eath from viral hepatitis B and C has surpassed HIV/AIDS in many countries, including Australia and in Western Europe, according to an analysis of the 2010 Global Burden of Disease study. The analysis was conducted by Dr Benjamin Cowie and Ms Jennifer MacLachlan from the University of Melbourne and Melbourne Health, and was presented at The International Liver Congress in London earlier this month. “Liver cancer is the fastest increasing cause of cancer deaths in Australia, increasing each year by 5 per cent, so by more than seventy people each year. In 2014 there was an estimated number of deaths of around 1,500 from liver cancer. The predominant cause is chronic viral hepatitis,” Dr Cowie said. Hepatitis refers to the inflammation of the liver. Chronic infection with the blood-borne viruses hepatitis B or hepatitis C can result in scarring of the liver (cirrhosis) or potentially liver cancer at a later stage – however these risks can be reduced through access to effective care and treatment. Dr Cowie said additional resources were needed to prevent and treat hepatitis B and C in order to address these imbalances in major preventable causes of human death. 6
“The release of the Global Burden of Disease (GBD) 2010 results provides a unique opportunity to set global and local priorities for health, and address previous imbalances in addressing the major causes of preventable causes of human death, among which hepatitis B and C must clearly be counted.” “The Commonwealth Government has recently committed to funding initiatives to improve access to testing and treatment for people from priority populations living with hepatitis B in Australia, which is a great step forward,” he said. “The GBD estimated around 1.3 million people lost their lives to viral hepatitis since 1990, which is comparable to the respective burdens of HIV/ AIDS, tuberculosis and malaria,” Dr Cowie concluded. The GBD 2010 is the most recent version of a study funded by the Bill and Melinda Gates Foundation. It is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries and health risk factors. The GBD 2010 has collated estimates of 291 diseases and injuries and 1,160 conditions that followed to identify the causes of human death worldwide.
BY UNIV. OF MELBOURNE.. Apr 17, 2014 Media Release for The Univ. of Melbourne.
NEW TREATMENTS FOR HEPATITIS C
C
hronic hepatitis C infections put people at high risk of cirrhosis of the liver, liver cancer and liver transplantation or even death after a long illness. In recent months the US has approved drugs which can raise the cure
rate to 90% and higher, with fewer side effects and no need for injections. This medication is under evaluation in Australia, but will be almost unaffordable with costs around $100,000.
BY ABC NEWS.. May 5, 2014 for ABC News. tinyurl.com/new-hep-c-drugs
GROUP URGES ‘National dialogue’ on cost of new
Hepatitis C drug
T
he outcry continues over the $1,000-a-pill hepatitis C drug made by California-based Gilead Sciences.
While the drug is a significant advance over older treatments for the viral liver disease, the price set by the company “represents an abuse of market power,” said John Rother, president and CEO of the National Coalition on Health Care, which includes businesses, unions, insurers, consumers and some drugmakers, including the Generic Pharmaceutical Association. On Wednesday, the group urged a “national dialogue” on the cost, saying Sovaldi’s price tag threatens the budgets of government-run health programs as well as the premiums for everyone who has private insurance. Gilead has defended Sovaldi’s price, saying the cost – at least $84,000 for a typical patient – is justified because the drug is curative for many and could slow health spending on costly complications of hepatitis over time.
HEPATITISWA Newsletter // June 2014 Disclaimer: The news articles and excerpts displayed in the HepatitisWA Newsletter remain the copyright of the original authors and news publications.
Community news
All insurers are currently setting guidelines for the use of Sovaldi and another new costly hepatitis C drug called Olysio. While some are making it broadly available, others are saying some patients with mild liver damage should wait for treatment. More hepatitis C drugs are expected on the market as early as this autumn – and, unlike Sovaldi, may not require the use of additional drugs that add costs as well as difficult side effects. Rother says that officials from Gilead have talked with his group, but so far only in a “defensive” posture over the price. Instead, he wants them to “engage” in conversations about ways to lower the drug’s price. The coalition joins others – notably pharmacy manager Express Scripts – in calling for a “national dialogue” on drug pricing, although it could not point to an example where that has lowered drug prices in the past.
BY KAISER HEALTH NEWS. Excerpt published on May 29, 2014 for Kaiser Health News. tinyurl.com/group-dialogue
HEPATITIS B RISK IN GAMBIAN CHILDREN
E
arly age at infection with hepatitis B virus (HBV) increases the risk of chronic HBV infection. In addition early age at infection
may further increase the risk of persistent viral replication beyond its effect on chronicity. The effects of perinatal and early postnatal transmission on the risk of prolonged hepatitis B e antigenaemia in children with chronic HBV infection are not well documented in Africa. We examine these associations using maternal HBV sero-status and the number of HBV-positive older siblings as proxy measures for perinatal and early postnatal transmission. Methods: Hepatitis B e antigen (HBeAg)-positive mothers were identified in six population-based HBV sero-surveys conducted in The Gambia between 1986 and 1990. For every HBeAg-positive mother, a hepatitis B surface antigen (HBsAg)-positive HBeAg-negative mother and HBsAg-negative mother were randomly selected from the population surveyed. These mothers and their family members were tested for HBV sero-markers in a subsequent survey conducted between 1991 and 1993. Results: Thirty-eight HBeAg positive mothers and the same number of HBsAg-positive HBeAg-negative mothers and HBsAg-negative mothers participated in the study.
Sixty-nine percent of their children also participated. There was a non-significant positive association between HBeAg prevalence in children and the number of HBeAg-positive older siblings (64.1%, 69.2% and 83.3% in children with 0, 1 and >=2 HBeAg-positive older siblings, respectively). After adjusting for confounders, having an HBeAg-positive mother was a risk factor for HBeAg positivity in children carrying HBsAg (adjusted OR 4.5, 95% CI: 1.0-19.5, p = 0.04), whilst the number of HBeAg-positive older siblings was not. Conclusions: Maternal HBeAg was associated with positive HBeAg in children with chronic HBV infection. This suggests that interrupting mother-to-infant transmission in sub-Saharan Africa might help reduce the burden of liver disease. A timely dose of HBV vaccine within 24 hours of birth, as recommended by World Health Organisation (WHO), should be implemented in sub-Saharan Africa.
BY BMC PUBLIC HEALTH.. May 30, 2014 for BMC Public Health. tinyurl.com/hep-b-gambian-kids HEPATITISWA Newsletter // June 2014
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HEALTH & LIFESTYLE FEATURE
n o s r e p e
C th
e s a e s i d he
t t o n
This8campaign has been reproduced with2014 permission from Hepatitis NSW ‘s C the person not the disease campaign Jan 2014. HEPATITISWA Newsletter // June Image available courtesy of Hepatitis NSW Copyright © 2014.
Did you know? • There are 230,000 people in Australia living with chronic hepatitis C; • Many people living with hepatitis C are reluctant to disclose their status due to stigma and discrimination; and • Studies have shown that people living with hepatitis C face discrimination which can act as a barrier to accessing treatment and making healthy lifestyle changes. Almost 1 in 3 people living with chronic hepatitis C report being discriminated against by a health professional on the basis of having hepatitis C. In the month of July to coincide with World Hepatitis Day (28th July), HepatitisWA will launch the C the person not the disease campaign to help raise awareness of hepatitis C, with a view to increasing access to testing, treatment and care. The campaign is targeted to GPs, allied health professionals, and the general community. To show your support, or to learn more about the campaign, hepatitis C, and current treatments, please visit www.ctheperson.com.au.
HEPATITISWA Newsletter // June 2014
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FEATURE
IS AN $84,000
treatment DRUG
A
n $84,000* hepatitis treatment drug called Sovaldi is at the center of a new battle between pharmaceutical companies and insurers — but the fight is about much more than one drug.
Sovaldi costs $1,000 per day, or $84,000 for a full treatment, and cures 90 percent of hepatitis C patients who take it. Insurers say the drug is ridiculously overpriced; the pharmaceutical industry says it’s a steal. But the debate here isn’t simply about one hepatitis drug. Sovaldi is more like a single skirmish that has reawakened a broader, deeper, and higher-stakes cold war over the cost of prescription drugs. Officials in both industries say that even if Sovaldi’s manufacturer, Gilead, slashed its prices, the newly intensified battle between insurers and pharma companies wouldn’t recede: Sovaldi is just the beginning. Sovaldi is a lightning rod because insurers and consumer advocates are afraid it’s a sign of what’s to come. The drug pipeline is full of drugs like Sovaldi, and insurers say that flood of new, expensive products will cause health care spending to skyrocket. “I think that this one drug is the canary in the coal mine. It’s one that is out front and one of the first ones we’re seeing, but there are a lot more down the pipeline,” said Brendan Buck, a spokesman for America’s Health Insurance Plans. Until Sovaldi, the class of products known as “specialty drugs” was mainly tailored to relatively rare conditions. The drugs are complex, which makes them more expensive to produce, driving up the price for consumers. And because they treat rarer conditions, there were fewer potential customers—another factor driving up prices. Specialty drugs have always been expensive. They account for roughly 25 percent of
U.S. spending on prescription drugs, but just 1 percent of all prescriptions, according to a newly formed coalition lobbying for lower prices. But Sovaldi set off a particular shock wave largely because it treats a more common ailment — some 3 million people have hepatitis C. They can’t all afford an $84,000 course of treatment, but still, critics argue, the drug’s large potential customer base means that a once-narrow slice of drug spending could explode. “If this sets a pattern for other drugs then we’re really in deep trouble... it’s the combination of the price and the volume,” said John Rother, who helped start the Coalition for Sustainable Rx Pricing. The new organization, which also includes AARP and other health care advocates, launched Wednesday.
Source: Article written by Sam Baker for The National Journal. May 29, 2014. URL: www.tinyurl.com/1000-dollar-pill 10 HEPATITISWA Newsletter // June 2014 Image courtesy of Justin Sullivan/Getty Images. © All Rights Reserved.
HEPATITIs
TOO EXPENSIVE?
A pharmaceutical industry official said insurers’ effort to crack down on Sovaldi and other specialty drugs is short-sighted. The insurance industry is under tremendous pressure to keep premiums low, especially in the first few years of Obamacare enrollment, and it’s reacting to that pressure by steering health providers and consumers away from products that are more expensive in the short term, the official said — but is running the risk of foregoing longer-term savings. The basic dynamics underneath this tension are nothing new: Pharmaceutical companies want insurers to cover their drugs, which helps them make money; insurers want to avoid shelling out tens of thousands of dollars for expensive treatments, which helps them make money. But the Sovaldi dust-up has turned up the intensity, as insurers make an aggressive case that they’re not the ones to blame if rising health care costs drive up premiums.
The pharmaceutical industry says critics are missing the point. Yes, Sovaldi is expensive, it argues, but that’s because it works. Sovaldi cures about 90 percent of patients with a common form of hepatitis C within its 12-week course. Spending $84,000 on a cure might seem expensive up front, but it’s a lot more efficient in the long run than paying for a string of less effective treatments, including hospitalizations that run the risk of complications, the drug industry says. A report from Optum, a consulting subsidiary of United Healthcare, agrees. Even very expensive drugs can be cost-effective if they work well enough, Optum said in a report issued before Sovaldi’s price was released. “It is certainly possible that the combination of higher cure rates and reduced side effects, combined with reduced treatment times, may mean even greater cost-effectiveness in the future,” Optum’s analysts wrote.
“The reality is that the company in this case is asking for a blank check, and we can’t give anyone a blank check in the health care system… because it will blow up family budgets, it will blow up state Medicaid budgets, it will blow up employer benefit costs, and it will wreak havoc on the federal debt,” AHIP President and CEO Karen Ignagni said at a recent event sponsored by The Atlantic.
*$84,000 USD is equivalent to approx. $90,000 AUD at the time of printing. This medication is under evaluation in Australia and is not generally available. Please see the article on the following page for information on current treatments in Australia. HEPATITISWA Newsletter // June 2014
11
CURREnT HEPATiTiS C
TREATMEnTS CURREnT TREATMEnT FoR GEnoTYPE 2 & 3 The current treatment (combination therapy) specifically for hepatitis C genotype 2 and 3 is still a combination of the two drugs interferon and ribavirin. Interferon is a drug taken by injection under the skin (subcutaneously) once a week which may increase a person’s immune response and stop the growth of the hepatitis C virus in the body. Ribavirin is a drug taken orally twice a day and it interferes with the hepatitis C virus RNA metabolism.
In relation to the hepatitis C virus, when these drugs are administered together they may stop or slow down the disease process.
The treatment is administered over a 6 month period usually with a success rate of up to 80% (8 out of ten people will be cured). Some people report no side effects while others may have flu-like symptoms, fatigue, headaches, muscle pain, skin rashes, anemia and particularly psychological problems such as depression, loss of concentration and mood swings. It should be noted that the side effects are not experienced by everyone undertaking treatment. The degree to which they are experienced is variable and are usually experienced in the first few months of treatment.
Source: Information originally published on HepatitisWA’s website. URL: www.tinyurl.com/hep-c-treatments 12 HEPATITISWA Newsletter // June 2014 Image available under a creative commons license at www.freeimages.com. Photography by Brian Hoskins. Copyright © 2008.
Community news
NEW TREATMENTS FOR GENOTYPE 1 A new combination triple therapy treatment for hepatitis C genotype 1 is now available. The new combination includes weekly interferon injections with daily ribavirin tablets, and also includes a daily course of boceprevir or telaprevir tablets (oral medications which must be taken three times daily). The success rate for the treatment of hepatitis C genotype 1 using these new treatments has increased from 40% to 70%. The side-effects of pegylated interferon and ribavirin may still occur in addition to side effects caused by boceprevir or telaprevir, but for a shorter duration. Boceprevir triple-therapy regimen should be taken with a light meal or snack. For the first 4 weeks of treatment only interferon plus ribavirin must be taken with Boceprevir being added at week 5. Interferon, ribavirin and boceprevir must be taken for 24-44 weeks. The most common side effects of boceprevir in combination with interferon/ribavirin includes fatigue, anemia, nausea, headache, and a change in taste. In some patients, anemia may become severe. (Anemia is a decrease in number of red blood cell or less than the normal quantity of haemoglobin in the blood). Telaprevir triple-therapy regimen should be taken with food containing approximately 20 grams of fat. Telaprevir, interferon and ribavirin must be taken for the first 12 weeks of treatments and then telaprevir is stopped and interferon and ribavirin is continued for an additional 12 to 36 weeks. The most common side effects of telaprevir in combination with interferon/ribavirin includes rash, with and without itchiness, and anemia. Although rash is usually mild, it can become severe. It is important to remember that everyone is different and side-effects from treatments vary from person to person. If anemia and rashes become severe the treatment will be stopped.
FUTURE TREATMENTS The ultimate goal of future treatment for hepatitis C is to provide interferon-free treatment to all Australians living with hepatitis C. However these treatments are still in development and have not yet been approved for use in Australia at the present time. Please contact your doctor for further information on hepatitis C treatment or call us at HepatitisWA on (08) 9328 8538 (Metro) or 1800 800 070 (Country). HEPATITISWA Newsletter // June 2014
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live healthy with hep C
HEALTH & LIFESTYLE
14
How can I live healthy with hepatitis C? In most cases, hepatitis C virus (HCV) is an illness where changes happen slowly, and you may not have symptoms for a long time, if ever.
What can I do now about my health and health care? Take charge of your health and your health care by learning all you can about hepatitis C. Health care providers may be experts in some areas and not others, so you may find that you need to approach
Try to avoid illness Other viruses, such as hepatitis A or B, can damage the liver. Talk to your health care provider about getting immunized for these diseases and others (such as the flu). Avoid illicit drugs The use of illicit drugs is not good for your health and can harm your liver. Heavy or moderate use of marijuana products may increase scarring of your liver. Injecting, inhaling or smoking drugs with shared equipment may
HEPATITISWA Newsletter // June 2014
different people for different things to help you. Get involved in decisions about your health care – ask questions and make suggestions. Remember, your health care providers are experts in their jobs, but you know your body the best. If you do not have a health care provider, you may find other people or groups can help you. Check out community and regional health centres, street health clinics, outreach services, public health clinics, or contact the Hepatitis Helpline on (08) 9328 8538 (Metro),
infect you with another type of hepatitis C, hepatitis B or HIV. Remember, you can be infected with more than one type of hepatitis C at the same time, and some types are harder to treat than others.
or 1800 800 070 (Country). Once you find a good source of care, try to stay with it, as it will make your health care planning much easier.
What healthy choices can I make? Your liver has many jobs – from cleaning your blood to turning the food you eat into energy for your body. Avoid or limit alcohol The use of alcohol can cause HCV to damage your liver more quickly and will make your treatment less effective.
HepatitisWA provides sterile equipment through our Needle and Syringe Program (NSP), and we are open from 9am to 5pm, Monday to Friday.
If you do use illicit drugs, make sure you have your own sterile equipment (syringes, cookers, filters, water, tourniquets, pipes, straws) and never share any of it. Inject yourself rather than have someone else inject you.
Source: Canadian Liver Foundation (2007). LIVERight: Healthy Living with Hepatitis C. URL: www.liver.ca Images available under a creative commons license at www.freeimages.com. Photography by Ariel da Silva Parreira. Copyright © 2014.
Two or more drinks a day can increase the rate of scarring in your liver and may speed up the development of cirrhosis and possible liver cancer. Every time you choose not to have a drink, you are doing something good for your liver.
Smoking increases the risk of liver cancer if you have hepatitis C. Also, tobacco harms your lungs. If you have lung disease and your hepatitis C worsens and causes cirrhosis and liver failure, your chances of a successful liver transplant will be much more What is a “standard drink�? limited. If you smoke, try to A standard drink is any drink stop. If you need help, talk containing about 10g of to your health care provider. alcohol. Eat healthy Avoid or limit tobacco Healthy eating gives your body Tobacco contains several and mind the fuel they need cancer-causing agents. More to do their work. Because the cancer-causing agents can be liver processes everything you found in many of the eat, eating well can help chemicals added to tobacco keep your liver healthy. products when they are made. Eat healthily to give your
body the right balance of carbohydrates, protein and fat. If you have cirrhosis or poor liver function, you may need a special diet such as a low-sodium diet to prevent water build up in your body. In this case, talk with your health care provider. To find an Accredited Practising Dietitian, go to the Dietitians Association of Australia website www.daa.asn.au.
is about putting time aside just for you, every day.
at night, try taking breaks or naps when you feel tired during the day.
Get moving Being active helps your body stay healthy. It helps you manage stress, feel better, and reach and maintain a healthy weight. Being active can also help with other symptoms of HCV like joint pain and fatigue. Being active in a way that you enjoy is important. Your choice will depend on how fit you are and how your body reacts to exercise.
What else can I do to stay healthy? There is a lot you can do every day that will help to protect your liver from damage and keep you feeling good. Here are some things to think about.
Get adequate sleep
Not getting enough sleep can make you feel less well overall. It can also contribute to the fatigue that some people with hepatitis C feel. If you are not getting any exercise during the day, start being more active so you will feel physically tired at the end of the day. Do not eat or exercise too close to bedtime. Before starting a new exercise Try relaxation tapes, meditation program, speak with your or deep muscle relaxation GP. Whichever activity you to help with sleep. Reading choose, start slowly and in bed can help relax your mind. work your way up. Exercise If you have trouble sleeping HEPATITISWA Newsletter // June 2014
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COMMUNITy NEWS
A SNAPSHOT OF HEPATITISWA EVENTS Hepatidings Contributors: Nadia, Matt, and Amineh. Photographs by: Felicia. HepatitisWA would like to welcome our newest staff members Amineh (Support services), Brenna (health promotions), and Amanda (Community engagement).
L - R: Amineh, Brenna and Amanda.
oUR volUnTEERS National Volunteer Week was celebrated during the week 12th – 18th May. This was a great opportunity for HepatitisWA to thank our volunteers for their ongoing passion and commitment in volunteering with our organisation. We currently have approximately 18 active volunteers who dedicate their spare time to do shifts in our Needle and Syringe Program (NSP), provide support on our Hepatitis Helpline, and also assist in health promotion events and activities. We held a scrumptious morning and afternoon tea for our volunteers on Monday 12th May, and used the opportunity to catch up for a laugh. We recognise the contribution of all of our volunteers over the years – they are the spirit and backbone of our organisation. Again, HepatitisWA would like to say “THANK YOU!” 16
HEPATITISWA Newsletter // June 2014
and Syringe Vending Machine at Armadale hospital. This is the first machine of its type ever installed in a metropolitan health service in WA, and will dispense fitpack products 24 hours a day at a cost of $3 per pack. HepatitisWA has recently provided training around hepatitis C as it relates to drug related harm at the NSP coordinators training in Perth. This workshop aims to increase the confidence of NSP workers throughout regional WA to be able to provide health information in the form of brief interventions to clients accessing their services. In addition, HepatitisWA also provided an overview on NSP and hepatitis C at the Disease Control Conference in Broome, as well as some other health services within the region such as the Broome Hospital. One result of these workshops was the establishment of a community lead NSP reference group for the Kimberley, which provides the region with a platform to discuss trends and issues related to hep C and NSP affecting their communities.
SUPPoRT GRoUP
Celebrating national Volunteer Week
nSP EnHAnCEMEnT HepatitisWA continues to advocate for the enhancement of needle and syringe program (NSP) strategies to a wide range of services throughout Western Australia. Over the past few months HepatitisWA has assisted in the implementation, promotion, and evaluation of the new Needle
Our Support Group is formed as an opportunity to provide an enabling environment for individuals who share common issues and are challenged by similar life situations. By coming together, people can provide common support, and take the steps necessary to make positive changes in their lives. HepatitisWA provides peer support through telephone contacts, formal peer support groups and regular organised social activities. Our support group gives people with hepatitis C peer support and education in an open, comfortable, and a nonjudgemental environment.
MEMBERSHIP RENEWAL
ABN 42743157642
AnnUAl MEMBERSHiP REnEWAl FoRM 2014/2015 TAX INVOICE Please complete your details below in block print, cut-out and return with payment First Name (Mr/Mrs/Ms/Dr):______________________________________________ Last Name:____________________________________________________________ Agency/Organisation:____________________________________________________ Address:_______________________________________________________________ Suburb/Town:_____________________________ State:________ Postcode:________ Phone:____________________________ Email:______________________________ Payment options
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Associate/Organisation
$55.00 incl. GST
or 2 - Attach a copy of EFT receipt BSB 066118 Acct 10021906 HepatitisWA and
Mail to:
HepatitisWA (Inc) PO Box 67 Francis St, Northbridge WA 6865
or 3 - Pay in person at
HepatitisWA 134 Aberdeen St, Northbridge
HepatitisWA (Inc) is an income tax exempt charitable entity and deductible gift recipient. Your membership and ďŹ nancial support enables us to continue our work in responding to hepatitis. Our quarterly newsletter, the HepatitisWA Newsletter, which carries the latest information on hepatitis C and related viral hepatides, is forwarded to all our members. HepatitisWA (Inc) PO Box 67 Francis St, Northbridge WA 6865
t (08) 9227 9802 f (08) 9227 6545 email info@hepatitiswa.com.au Information (08) 9328 8538 Metro - 1800 800 070 Country Web www.hepatitiswa.com.au HEPATITISWA Newsletter // June 2014
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WASUA’S DOMAIN THE WEST AUSTRALIA SUBSTANCE USERS ASSOCIATION
WASUA’S HEALTH SERVICE WASUA
would like to introduce our new nurse, Jo, who runs our health clinic at the WASUA office in Murray Street. WASUA prides itself on having an up to date, reliable, confidential and as broad as possible health clinic. Jo comes experienced from having worked in prisons and other front line services. Our health clinic has regular days in which people can access services for free and with an enthusiastic, professional nurse Jo, who is user friendly eliminating going through any sort of stigma or discrimination visiting another not user friendly service. The nurse can be visited any time each Tuesday and Thursday without an appointment from 10:00am until 4:00pm, without any cost and with total confidentiality. Available services through the clinic include blood tests, sexual health, tests and treatment, vaccinations and general health services underlined with harm minimization messages. 18
HEPATITISWA Newsletter // June 2014
Jo recommends that EVERYONE who has sex or injects drugs should have a blood test every six months for Blood borne viruses (BBV’s) and to identify any issues with your sexual health in the form of sexually transmitted infections (STI’s). Testing – A general STI/BBV test will include testing for Hepatitis A, B and C, HIV, Syphilis, Gonorrhea and Chlamydia. Keeping regular with
testing increases awareness and helps damaging with sometimes irreversible prevent the spread of STI’s and BBV’s. effects. PCR testing is also available for those already diagnosed with hepatitis C. Referrals – to hospital for the treatment of hepatitis (Liver Clinics) and STI’s. A liver function test – Gives a sign of how the liver is functioning and how Vaccinations – For hepatitis A and B. much of an effect hepatitis is having Hepatitis A is a set of two injections on the general functioning of the liver. whereas hepatitis B requires three injections over a period in order to last Genotyping – This will tell whether you at least 10 years. These are free through are hepatitis C genotype 1, 2 or 3 which WASUA and so Jo is encouraging everyone who has not had these is needed if you want to undergo vaccinations to come in and have treatment. them done. It is especially important for those who may have hepatitis or Sexual Health – people are more HIV. Flu vaccinations are also available than welcome to talk to Jo about their where all are encouraged to take part in sexual status, practices and concerns, as winter approaches. including male and female condom use General Health – and basic wound and safe sex issues. There are some dressing. As Jo says she is happy to talk very common STI’s like Chlamydia and to anyone about any health issue and Gonorrhea circulating around now if it is out of her knowledge base, she so staying on top of testing will let u is happy to refer on to other services. know sooner rather than later if you are Written by Mikayla-Jay McGinley infected, later can be much more Hepatitis C Educator, WASUA.
PERTH
SOUTH WEST
Van Phone 0417 973 089 Office (08) 9791 6699
(08) 9321 2877 www.wasua.com.au Perth NSEP Mon - Weds: 10am-4pm Thurs - Fri: 10am-8pm Sat & Sun: 10am-12pm
Clinic Hours Tues & Thurs: 10am-4pm Closed Public Holidays
WASUA provides a number of services on premises at 519 Murray Street, West Perth, including: • • • • • • • • •
NSEP (Needle and Syringe Exchange Program) Free hep A and B vaccinations for hepatitis C positive people Free blood testing in a friendly confidential environment Drug treatment support and referral Peer education and training Street-based outreach Advocacy and support for users Safe injecting and safe disposal education and resources Hepatitis C/blood borne virus information and resources
South West Mobile provides a mobile Needle Syringe Exchange Program (NSEP) at the following locations and times: Margaret River Busselton Jaycee Park, Bunbury Hudson Road, Bunbury Bunbury Hospital Manjimup Harvey Donnybrook Collie
Tues: 1pm-2pm Hospital Carpark Tues: 5pm-7pm Kevin Cullen Community Health Wed: 4:30pm-5:30pm JC Park Wed: 5:45pm-6:45pm WA Country Health Service Wed: 7pm-8pm Dental Clinic Carpark Thurs: 5pm-6pm Hospital Carpark Thurs: 6pm-7pm Hospital Carpark Fri: 4pm-5pm Hospital Carpark Fri: 6pm-7pm Ngalang Boodja (Corner Forrest St & Atkinson St)
HEPATITISWA Newsletter // June 2014
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For more information, please contact Amineh on 9328 8538 or support@hepatitiswa.com.au