Hepatitis C is more common in people with mental illness than it is in the general population but recent medical advances present an opportunity to address this. In a new campaign called Change of Mind, Hepatitis NSW is encouraging people who live with hep C and who also experience mental health issues, to find out about changes in the treatment of hep C.

In March 2016, the hepatitis C treatment landscape in Australia changed completely. New Direct Acting Antiviral (DAA) medicines were added to the PBS, drugs with very high cure rates (95%), working in as little as 8-12 weeks. These DAAs do not require injections and importantly they have minimal side-effects – replacing previous hep C drugs that caused mental health side-effects, including causing or exacerbating depression and psychosis.

However, despite the fact more than 30,000 Australians started hep C treatment in 2016 alone, there is concern that people living with mental illness are missing out. To remedy this, Hepatitis NSW is working BEING NSW to promote hep C treatment both among mental health professionals and consumers.

The campaign is needed for a variety of reasons, including the fact that the prevalence of hepatitis C in people with mental illness is higher than it is in the general population. While it is difficult to estimate the exact proportion of people with mental health issues in Australia who have hep C, academic studies have found rates of between 3% and 42% amongst people in Australian psychiatric hospitals[1], compared to just 1% population-wide.

The hep C of people who experience mental health issues may have been overlooked or undertreated in the past due to a focus on mental health issues. Another challenge to address are out-dated views about hep C treatment. The old, interferon-based treatments had significant, often debilitating, side-effects, and were particularly tough on people with mental health issues, including depression. As a result, people living with both hep C and mental illness may understandably be wary about starting treatment – but they do not need to be, as the new DAAs have much reduced side-effect profiles, and are not contraindicated for people with mental health issues.

The benefits of treating, and curing, hep C are considerable. There were an estimated 818 deaths related to hep C in 2015 alone[2]. Left untreated, after 20 years 47% of people living with hep C develop moderate liver damage, 7% develop cirrhosis, and 1% liver cancer or liver failure. Hep C is also increasingly connected with a range of other illnesses, including type 2 diabetes[3], chronic kidney disease[4], and “lymphoproliferative disease, atherosclerosis, cardiovascular and brain disease”[5].

Treatment and cure of hepatitis C has a positive impact on the incidence and/or progression of all of these physical illnesses. Even people who don’t have noticeable symptoms benefit from treatment with many reporting having more energy and a new lease on life. Now that safe and effective treatments are available, there is no reason why people living with both hep C and mental illness should miss out on these benefits.

The ‘Change of Mind about hep C treatment’ campaign will emphasise three specific messages:

  1. Hep C is higher among people with diagnosed mental health issues
  2. The good news is that hep C can be easily treated, and cured
  3. Even more good news: curing hep C can have multiple health benefits, including mental health benefits

People who experience mental health issues and hepatitis C deserve the chance to live better, healthier and longer lives.  Now is an excellent time for anyone with mental health issues to be diagnosed and treated for hep C.  Get behind this campaign, and help make hep C treatment a reality. For more information about hep C, and the new treatments, visit www.hep.org.au or call the Hepatitis Infoline on 1800 803 990.

Hepatitis NSW is calling for expressions of interest from people who have experience of mental illness and hep C to be champions for the project. If you are interested in championing the treatment of hep C among people who have experience of mental health issues contact David Pieper dpieper@hep.org.au or 02 9332 1853

[1] Rose Grenville, Cama Elena, Brener Loren, Treloar Carla (2013) Knowledge and attitudes towards hepatitis C and injecting drug use among mental-health support workers of a community managed organisation. Australian Health Review 37, 654-659

[2] The Kirby Institute, Hepatitis B and C in Australia: Annual Surveillance Report Supplement 2016.

[3] Hammerstad, S. S., Grock, S. F., Lee, H. J., Hasham, A., Sundaram, N., & Tomer, Y. (2015). Diabetes and Hepatitis C: A Two-Way Association. Frontiers in Endocrinology,6, 134. http://doi.org/10.3389/fendo.2015.00134

[4] A nationwide cohort study suggests that hepatitis C virus infection is associated with increased risk of chronic kidney disease. Chen YC, Lin HY, Li CY, Lee MS, Su YC Kidney Int. 2014 May; 85(5):1200-7

[5] Zampino, R., Marrone, A., Restivo, L., Guerrera, B., Sellitto, A., Rinaldi, L., … Adinolfi, L. E. (2013). Chronic HCV infection and inflammation: Clinical impact on hepatic and extra-hepatic manifestations. World Journal of Hepatology, 5(10), 528–540. http://doi.org/10.4254/wjh.v5.i10.528

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