Hepatitis C Discussion Document Released
12 April 2002
Future directions to control and prevent Hepatitis C in New Zealand are explored in a draft discussion document released today by the Ministry of Health.
Action on Hepatitis C Prevention: A discussion document was developed by the Ministry in consultation with a group of experts and involves the development of an action plan to prevent the spread of Hepatitis C in New Zealand.
"The transmission of Hepatitis C, a viral infection of the liver, is a global health concern," said Ministry Spokesperson Dr Doug Lush.
"It is very difficult to estimate how many people have Hepatitis C. However, worldwide it has been estimated that 170 million or about three percent of the world population are infected with Hepatitis C and around three-four million people are newly infected each year.
"In New Zealand it has been estimated that approximately 25,000 people are currently living with the virus and this number is predicted to increase by 50 percent in the next ten years."
The document aims to open discussion on how to prevent the future spread of Hepatitis C, based on an analysis of international and domestic evidence.
Public submissions are due at the Ministry of Health by 15 May 2002 and the action plan will be developed after submissions are received.
The Hepatitis C Prevention Action Plan will be a step-by-step layout of what has to be done in order to reduce both the transmission and the personal and social impacts of Hepatitis C.
Hepatitis C is transmitted through exposure to infected blood.
"With today's high safety standards associated with our blood and blood products, the risks of transfusion-transmitted infections in New Zealand are extremely low and the greatest risk for transmission is through blood-to-blood contact involved with injecting drug use."
Dr Lush said the use of injecting drugs has become the single most important risk factor for acquiring Hepatitis C and accounts for around 80 percent of infections. Reducing Hepatitis C transmission in injecting drug users will be a high priority for the action plan.
The discussion document and details on how to make a submission are available on the Ministry of Health web site (www.moh.govt.nz).
Hepatitis C is primarily spread by contact with infected human blood and, previously, unscreened blood and blood products were a major source of infection. Since the introduction of screening of donated blood in 1992, the risk of Hepatitis C transmission in New Zealand through blood and blood products has become very remote.
Today the greatest risk of transmission is through blood to blood contact involved with injecting drug use. It is very difficult to estimate the number of injection drug users, but it has been estimated that approximately 13,500?26,600 people are opioid-dependent in New Zealand. As not all those who inject drugs are dependent or opioid users, the population risk is likely to be larger.
Acute Hepatitis C infection usually produces only a mild illness, and is often totally asymptomatic. Research has shown that approximately 25 percent of people with Hepatitis C will clear the virus within two to six months of becoming infected. The other 75 percent of people who do not clear the virus will have an ongoing, or chronic infection.
Chronic infection by Hepatitis C can lead to years of ill health, reduced quality of life and in some instances, social isolation. About half of those with chronic infection will develop cirrhosis, liver failure or cancer of the liver. However, these developments can take over 20 years or longer to develop.
Although Hepatitis C treatment with antiviral therapy can prevent progression to chronic liver disease, this therapy is limited by poor tolerability and poor efficacy. Other treatments are still in the early stages of development. Unlike Hepatitis A and Hepatitis B, there is currently no Hepatitis C vaccine available and the development of an effective vaccine is not imminent.
The key to the control of Hepatitis C therefore lies in prevention programmes focusing on those at risk of infection, and those who are already infected, to avoid further disease transmission.
Some of the current programmes for the control and prevention of Hepatitis C include: Provision of information to groups at risk about the risk of infection and means to reduce it; Provision of safe, clean injecting equipment to injecting drug users through needle exchanges; Provision of drug treatment programmes for injecting drug users; Screening and testing of human blood for transfusion; Application of standard precautions approach to minimise blood exposures in health care and other settings; Identifying and testing people at risk; and Providing information to people with Hepatitis C about ways to limit transmission to others and to prevent co-morbidity.