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Adherence For the best chance of a cure, it is vital that you take all medicines as directed by your doctor.

Mixing medicines If you are taking other medicines including over the counter drugs or herbal remedies, please check with your specialist as there may be harmful interactions which may affect your chance of a cure.

For information about clinical trials, talk to your doctor or viral hepatitis nurse. Information on clinical trials in Australia can also be found on the Australian Clinical Trials. Read more about it at http://bit.ly/ozclintrials.

Support and information

There are recognised drug interactions between these DAAs and some HIV medicines, antimycobacterials, St John’s Wort and some other common medicines.

Hepatitis SA can answer many of your questions and talk to you about any concerns you have. We can also put you in touch with other people who have been on treatment who can share their experiences. Having a supportive network of friends, family and services could be helpful if you decide to start treatment.

Monitoring treatment

How do I get started?

You will receive regular monitoring during treatment. This is done with blood tests that measure the level of virus in your blood.

The best way to get started on hepatitis C treatment is to contact the viral hepatitis nurses.

If the amount of virus in your blood drops to an undetectable level and remains undetectable for 12 weeks after you complete treatment, it is known as a Sustained Virological Response (SVR). This effectively means you are cured.

What if treatment doesn’t work? There is on-going research into new drugs and combinations so even if available treatments didn't work for you, stay in touch with your liver nurses or doctors. It is important to maintain regular liver health checks and keep up to date on when new and more suitable treatments may be available.

Hepatitis C Treatment

Central Adelaide Margery ‐ 0423 782 415 or Jeff ‐ 0401 717 953 Northern Adelaide Lucy ‐ 0401 717 971 or Trish ‐ 0413 285 476 Southern Adelaide Rosalie ‐ 0466 777 876 or Emma ‐ 0466 777 873 Vicki – 8204 4292

-----------------------Contact us Hepatitis SA – hepsa.asn.au 3 Hackney Road, Hackney SA 5069 T: (08) 8362 8443 | E: admin@hepsa.asn.au

Helpline: 1800 437 222 Department for Health and Ageing, SA Health has contributed funds towards this Program. Last updated: 8/02/2017

Hepatitis SA Helpline: 1800 437 222


Hepatitis C Treatment There are highly effective treatments for hepatitis C available on the Pharmaceutical Benefits Scheme (PBS). These treatments offer 90 per cent success rate for most people, shorter treatment periods and less side effects than previous treatments. The drugs available in Australia are Direct Acting Anti-virals (DAAs) including: sofosbuvir, daclatasvir, sofosbuvir/ ledipasvir and a combination of ombitasvir, paritaprevir, ritonavir and dasabuvir as well as grazoprevir /elbasvir.

Genotype test to determine which strain of the hepatitis C virus you have so that the most suitable therapy can be prescribed. Viral load test to determine the amount of virus in your blood. This is used as a baseline for monitoring your progress through treatment.

Your treatment nurse will also help you to be prepared physically so you are most able to cope with side effects, and talk with you about mental preparation and social supports during treatment.

Treatment

Alternative treatments include: - Sofosbuvir + pegylated interferon + ribavirin for 12 weeks

Genotype 4 treatment Genotype 4 hepatitis C can be treated with grazoprevir/elbasvir for 12 weeks or 16 weeks with or without ribavirin.

Other genotypes Call Hepatitis SA Helpline on 1800 437 222 for information on treatment for other genotypes.

Hepatitis C treatment regimens depend on genotype and other individual factors such as disease severity, co-morbidities and previous treatment experience.

The most common hepatitis C strains in Australia are genotype 1 (54%) and genotype 3 (37%). The therapies for these two genotypes are:

Side effects

Genotype 1 treatment

DAAs for hepatitis C are taken as tablets, mostly once a day, in various combinations with each other and/or with ribavirin and/or pegylated interferon. Most combinations are interferon-free.

Genotype 1 hepatitis C can be treated with:

Sofosbuvir - generally well tolerated with few recognised side effects.

Following is a brief outline about the new treatments. It is not meant to replace your doctor's advice. Your specialist will advise you on the best treatment option for you and provide details about the regimen prescribed for you.

Preparing for treatment

- Sofosbuvir + daclatasvir with or without ribavirin for 12 to 24 weeks. - Sofosbuvir/ledipasvir (Harvoni®) for 12 to 24weeks. This combination comes precombined in one tablet. - Ombitasvir + paritaprevir + ritonavir tablets and dasabuvir tablet (also known as Viekira Pak) for 12 to 24 weeks, with or without ribavirin. - Grazoprevir/elbasvir for 12 weeks or 16 weeks with or without ribavirin.

If you are considering treatment your viral hepatitis nurse will ensure that all the necessary tests are done before you begin. The tests may include:

Genotype 3 treatment

- Sofosbuvir + daclatasvir for 12 to 24 weeks - Sofosbuvir + ribavirin for 24 weeks

Fibroscan – a non-invasive scan to assess the extent of fibrosis, if any, in your liver.

First line treatment for hepatitis C genotype 3 consists of:

Possible side effects for the new DAAs, interferon and ribavirin are as follows:

Daclatasvir - fatigue, nausea, headache and diarrhoea. Sofosbuvir/ledipasvir (Harvoni) – fatigue and headache. Viekira Pak – nausea, itching, insomnia, weakness, tiredness, headaches, anaemia. Interferon - flu-like symptoms, nausea, weight loss, depression, mood disturbances, anaemia, impaired blood clotting, dry skin and hair-thinning. Ribavirin - anaemia, rashes and nausea. Associated with birth defects. Contraception is essential for BOTH men and women during, and for six months after, treatment.

Hepatitis C Treatment  

Updated Feb 2017. Printed copies of this resource are available from Hepatitis SA - email admin@hepsa.asn.au

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