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Way forward on hep C blood products infections

Hon Pete Hodgson
Minister of Health

5 December 2006 Media Statement

Way forward on hep C blood products infections

A $30 million package to provide one-off payments to an estimated 550 people is part of a way forward for people who were infected with hepatitis C through the New Zealand blood supply, Health Minister Pete Hodgson announced today.

In addition, $5 million per year will be invested to improve access to, and uptake of, hepatitis C treatment services.

"An estimated 30,000 New Zealanders are living with hepatitis C," Pete Hodgson said. "It is a challenging condition to live with and manage for anyone, but it is an especially distressing diagnosis for the small minority of people who were infected through the blood supply before screening began in 1992.

"Today's announcement is a way forward for these people and their families. It is important to note, however, that today New Zealand's blood supply is regarded as one of the safest in the world."

As part of the package a one-off payment will be available to people who:

 Have been infected in New Zealand with the hepatitis C virus through blood or blood products where the blood was collected in New Zealand before 27 July 1992.

 Continue to test positive for the presence of the virus in their blood or have a record of a treatment, which has successfully cleared the virus.

 Choose to put their details forward so an amount can be calculated for them, choose to accept any calculated amount offered and then enter into a payment agreement with the Crown.

The maximum amount a person could be eligible for is around $70,000. Not all eligible people will receive that amount, as the amount will vary between individuals. As a result, some people might receive a much lower payment or no payment, especially when they have already received previous payments from ACC, from the government, or from other countries.

An advisory group will also be established to assist the Ministry of Health and District Health Boards improve hepatitis C treatment services to all people with hepatitis C, who are entitled to publicly funded health services.

All people who choose to accept the calculated amount on offer will receive a statement of acknowledgement from the Prime Minister on behalf of the New Zealand Government.
People who think they may be eligible for the one-off payment should call 0800 689 001 for further information.

The Government acknowledges the important role of the Haemophilia Foundation of New Zealand in working to meet the concerns of all those infected with the hepatitis C virus through contaminated blood and blood products.

QUESTIONS AND ANSWERS

Background:

The no fault package announced today is the third package for people who were infected with the hepatitis c virus through the New Zealand blood supply. Previously, fault based settlements were made with two groups of people:

 people who could prove they were infected between August 1990 when screening of donor blood for hepatitis C was recommended and 27 July 1992 when the screening was available nationwide (1998 settlement)
 people who could prove they were infected between February 1990 when screening was feasible and 27 July 1992 when it was available nationwide (2000 settlement)

While these settlements covered 113 people, two further groups of people were excluded:

 people who were infected before February 1990
 people with haemophilia, who were unable to prove they had contracted the virus after February 1990, as they had received transfusions both before and after that date

The Haemophilia Foundation of New Zealand has worked to meet the concerns of all its members infected with the hepatitis C virus through contaminated blood and blood products, but who were ineligible for the settlement offers.

How many people will be eligible for the package?

While people will receive different amounts depending on their particular circumstances, it is estimated that around 550 people will be eligible to receive payments.

How much will it cost?

It is estimated that the total cost of the package will $31 million. On top of this, $5 million a year will be invested in expanding access to and take up of hepatitis C treatment services.


What else is the Government doing to help/support people with hepatitis C?

The Government is providing an additional $5 million a year to improve access to, and uptake of, hepatitis C treatment services. An advisory group is being set up to assist the Ministry of Health and District Health Boards improve services to all people with hepatitis C. The advisory group will include consumer, clinical and district health board representatives

What is hepatitis C?

Hepatitis C is a blood-borne virus that affects the liver. It is transmitted when infected blood gets into another person's bloodstream. Some people clear the virus spontaneously however the majority of people do not clear the virus and will have an ongoing or chronic infection.

The hepatitis C virus was identified in 1988. As a result of this finding it became clear that it was the major cause of the hepatitis known as Non-A,Non-B hepatitis.

What are the symptoms?

Few people notice any symptoms when they are first infected with hepatitis C. Some people report symptoms a bit like having the flu. Some feel nausea, abdominal and back pain, and extreme tiredness. Most people do not experience any symptoms for the first ten years or more after their acute infection.

Symptoms of chronic infection can range from mild to severe and can occur continuously or in bouts. Fatigue, nausea, discomfort in the abdominal region and feeling ill if you drink alcohol or eat fatty foods are the most common symptoms.

How is hepatitis C transmitted?

Hepatitis C is transmitted by blood-to-blood contact. That means people, who received blood transfusions or blood products in New Zealand before screening of donor blood began in July 1992, may have contracted the virus.

People who share drug-injecting equipment, including syringes and needles, are also at risk. A small number of people may become infected through unsterile tattooing or body piercing practices or needle stick injuries. People in these groups will not be eligible for the one -off payment.

How do you know if you have hepatitis C - is there a test?

An antibody screen test can determine whether you have been exposed to the hepatitis C virus. A positive screen test means that you have hepatitis C antibodies in your blood. This does not always mean that you have hepatitis C. A separate type of blood test known as "the PCR test" (Polymerase Chain Reaction) is used to detect the presence of the virus in the blood. If the PCR test is positive then you have hepatitis C.


What is the treatment for it?

There is currently no vaccine for hepatitis C. In New Zealand pegylated interferon and ribavirin combination therapy is available for treating hepatitis C. The hepatitis C viral genotype (or strain) that is associated with a person's infection influences the treatment course duration as well as the success of the treatment. A course of treatment can be either 6 months or 12 months depending on the hepatitis C viral genotype. Combination pegylated interferon and ribavirin treatment is presently achieving an overall sustained viral clearance rate of 60 percent across all genotypes of the virus.

The side effects that are associated with interferon and ribavirin treatment means that not everyone is necessarily a candidate for treatment. Physicians considering treatment of patients with hepatitis C should discuss cases with a gastroenterologist or an infectious disease physician.


How many New Zealanders have hepatitis C?

It is estimated more than 30,000 New Zealanders have hepatitis C. The vast majority of these people will not have contracted the hepatitis C virus from the New Zealand Blood Supply and therefore will not be eligible for the one-off payment.

What is the history behind development of tests and testing of donor blood for hepatitis and HIV?

Hepatitis B screening of blood donors was implemented in New Zealand in 1971. The early test methods were relatively insensitive compared to the highly sensitive tests available and used today.

In 1985 New Zealand implemented screening of blood donations for HIV, as was the case in other developed countries.

Prior to 1990 there was no reliable screening test for hepatitis C that was commercially available. Hepatitis C was identified in 1988 and the first test was developed in 1989 after the identification of the virus. The test became commercially available in early 1990. A second generation test for hepatitis C with improved test performance was developed in 1991 and further enhancements to testing have continued to take place. For example, today molecular-based tests (Nucleic Acid Testing - NAT) capable of detecting the presence or absence of the hepatitis C virus are used alongside the hepatitis C antibody test assay to screen New Zealand's donor blood. NAT testing is also undertaken for HIV blood donor screening in New Zealand.

Testing for hepatitis C became feasible in February 1990, however, New Zealand did not introduce nationwide screening of blood donations for hepatitis C until 27 July 1992.


How safe is the New Zealand blood supply?

The New Zealand Blood Service (NZBS) was established in 1998 and its primary task is to provide safe, high quality blood, blood products and related services to New Zealanders wherever and whenever they are needed.

The NZBS ensures safety of blood and blood products in a number of ways. NZBS undertakes comprehensive testing of all blood donations using the most sensitive tests available anywhere in the world.

NZBS has also introduced specific steps in the processing of blood which more than satisfy international standards for the quality and safety of the final products. NZBS aligns itself with the Council of Europe Standards that apply to blood safety.

NZBS uses fractionated plasma products that are prepared by methods which have been proven over many years to be amongst the safest in the plasma fractionation industry.

An important step contributing to these safety thresholds is the careful selection of voluntary unpaid blood donors.

The New Zealand Blood Service's approach to blood safety has resulted in our blood supply being acknowledged as amongst the safest in the world.

ENDS

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