Northland part of Hep C cureSave
Northland is among locations worldwide where a drug to treat Hepatitis C is achieving a near-100 per cent success rate, raising hopes of an end to the debilitating liver disease's epidemic days.
PHARMAC began publicly funding Viekira Pak, a combination of four antiviral medicines, last July. As of two months ago in Northland, where up to 500 people have been diagnosed with Hepatitis C, and many more are suspected as undiagnosed, 73 patients have been cured, with just one known unsuccessful treatment.
The World Health Organisation expects Viekira and other antiviral drugs, combined with prevention programmes, to eradicate the virus as a public health problem by 2030.
Currently 50,000 New Zealanders are estimated to carry the blood-borne virus, although only half that number are diagnosed as yet. Globally, WHO estimates up to 150 million people live with the disease.
Northland DHB physician Dr Kaye Logan and Hepatitis clinical nurse specialist Sandra Meyst said the release of Viekira was "exciting" for patients of Genotype 1, representing around 60 per cent of patients.
Because of the origins of Hep C infection, including blood exchange from intravenous drug needles or tattooing equipment, many patients experienced, guilt, shame or stigma, intensified by the low success rate of the antiviral treatment options that were the norm until Viekira, they said. Those treatments were also expensive and sickened patients with side effects.
"For so many years it's been depressing to treat, very intensive, often disappointing, with patients unwell and miserable," Dr Logan said. "In my job you don't always cure people. It's nice to be able to cure something."
Those who have successfully taken the course of Viekira had had a "big emotional burden lifted," Ms Meyst added.
The next step in eliminating Hepatitis C as a public health problem would be ensuring that Viekira was safely prescribed and dispensed, and that GPs, who were able to treat patients without cirrhosis, understood its safety in terms of interacting with other drugs.
Other factors in the patient's health would also affect the success of Viekira, while GPs were being educated about the funding available to get Hep C victims engaging with their clinics.
"When the dust settles we will go out and reach people who don't see their GP and aren't treating their disease," Dr Logan said.
"We want to seek them out and give them treatment. In future we want to eradicate the disease, like with smallpox."
The main issue currently preventing all estimated 400-500 Hep C positive patients in Northland being treated was that Viekira was suitable only for genotype 1 patients.
Providing their genotype is suitable, all patients should eventually be receiving treatment once GPs were confident in prescribing Viekira and supporting patients through their 12-week course of treatment.
General practice nurses needed to be capable of monitoring blood results during the treatment, and it was essential that patients be free of alcohol, cannabis and medications that could interfere with Viekira.
"This can be complex, especially for psychiatric or respiratory patients," Dr Logan said.