15th December 2017, Volume 130 Number 1467

Ian Sheerin

New Zealand and Australia have a major hepatitis C virus (HCV) epidemic which is receiving inadequate public health policy attention. Currently there is a mix of factors that offer the…

Subscriber content

The full contents of this page is only available to subscribers.

To view this content please login or subscribe


There is potential to control and possibly eliminate the hepatitis C virus epidemic in New Zealand and in Australia. It can cause more advanced liver disease, liver cirrhosis and liver cancer but it is potentially preventable and curable. There is inadequate public health policy attention to preventing new infections and reducing barriers. There is a need for increased investment to reduce barriers, improve coordination and community awareness and to collaborate to engage with the affected population who can be stigmatised and marginalised.


New Zealand and Australia both now have the potential for a major public health success in controlling the hepatitis C virus epidemic. The burden of advanced liver disease and drug-related harm is increasing. However, a new range of anti-viral therapies have become available which offer a potential cure for most people with few side-effects. The epidemic is potentially preventable and hepatitis C is now curable. Although public health strategies for blood-borne viruses have been updated, they fall short of what is needed and should be upgraded with more emphasis on prevention, in order to achieve control of this epidemic.

Author Information

Ian Sheerin, Population Health, University of Otago, Christchurch. 


Dr Ian Sheerin, Population Health, University of Otago, 34 Gloucester St, Christchurch 8140.

Correspondence Email


Competing Interests

Dr Sheerin is Chairman of the Hepatitis C resource Centre Trust (Te Waipounamu) Inc, which has previously received New Zealand government funding to undertake educational activities to increase awareness about the causes and prevention of blood borne virus transmission.


  1. Kirby Institute. National blood-borne viruses and sexually transmissible infections surveillance and monitoring report, 2016. The Kirby Institute, UNSW Sydney, NSW. Available on http://kirby.unsw.edu.au Accessed June, 2017.
  2. Gane E, Stedman C, Brunton C, et al. Impact of improved treatment on disease burden of chronic hepatitis C in New Zealand. New Zealand Medical Journal 2014; 127(1407). http://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2014/vol-127-no-1407/6390
  3. Thompson AJV on behalf of the Gastroenterological Society of Australia. Australian recommendations for the management of hepatitis C virus infection: a consensus statement. Medical Journal of Australia 2016; 204(7). DOI:10.5694/mja16.00106
  4. Gane E, Stedman C. NZ Society of Gatroenterology HCV treatment guidelines. November 2016 update.
  5. Snow K, Scott N, Clothier HJ, et al. Limited provision of diagnostic services to Victorians living with hepatitis C antibodies, 2001–2012: a multi-level modelling analysis. Australian and New Zealand Journal of Public Health 2017; 41:193–8;DOI:10.1111/1753-6405.12560. Accessed April 2017.
  6. PHARMAC. Hepatitis C Treatments. World Hepatitis day – check and treat. 2017; http://www.pharmac.govt.nz/medicines/my-medicine-has-changed/ Accessed 2 Aug, 2017.
  7. The Kirby Institute. Monitoring hepatitis C treatment uptake in Australia (Issue 7). The Kirby Institute, UNSW Sydney, NSW, Australia. July 2017. Available at http://unsw.edu.au/report/monitoring-hepatitis-c-treatment-uptake-australia-issue-7-july-2017 
  8. http://fixhepc.com/hcv. Accessed August 2017 
  9. Best Practice. The treatment of hepatitis C has changed. Best Practice Journal 2016; Issue77SE. http://www.bpac.org.nz
  10. Hellard M, Horyniak D, Aitken C. Global epidemiology of hepatitis C. 2009. Chapter 5 in Dore G, Temple-Smith M, Lloyd A (eds). Hepatitis C an expanding perspective. 2009; IP Communications: Melbourne.
  11. Commonwealth of Australia. Fourth national hepatitis C strategy 2014–2017. Australian Government, Department of Health. Available on www.health.gov.au Accessed June 2017.
  12. Topp L, Maher L, Kaldor J. Transmission of hepatitis C virus. Chapter 6 in Dore G, Temple-Smith M, Lloyd A (eds). Hepatitis C an expanding perspective. 2009; IP Communications: Melbourne.
  13. World Health Organization. Global hepatitis report, 2017. Geneva: World Health Organization; 2017
  14.  Zibbell JE, Iqbal K, Patel RC, et al. Increases in hepatitis C virus infection related to injecting drug use among persons aged ≤30 years – Kentucky, Tennessee, Virginia, and West Virginia, 2006–2012. Morbidity and Mortality Weekly Report 2015, May 8/74(17); 453–458. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6417a2.htm Accessed 17 Jan, 2017.
  15. Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths- United States, 2010-2015. MMWR Morb Mortal Wkly Rep 2016; 65(50–51):1445–1451. http://www.cdc.gov/mmwr
  16. Meldrum ML. The ongoing opioid prescription epidemic: historical context. American Journal of Public Health 2016; 106; 8:1365–66. DOI: 10.2105/AJPH.2016.303297
  17. Berecki-Gisolf J, Hassani-Mahmooei B, Clapperton A, McClure R. Prescription opioid dispensing and prescription opioid poisoning: population data from Victoria, Australia 2006 to 2013. Australian and New Zealand Journal of Public Health 2017; 41:85–91. DOI: 10.1111/1753-6405.12568. Accessed Jan 2017. 
  18. Kim B, Nolan S, Lianping T. Addressing the prescription opioid crisis: potential for hospital-based interventions? Drug and Alcohol Review (March) 2017; 36:149–152. DOI: 10.1111/dar.12541
  19. Blanch B, Pearson SA, Haber PS. An overview of the patterns of prescription opioid use, costs and related harms in Australia. British J of Clinical Pharmacology 2014; 78:5:1159–1166. DOI:10.1111/bcp.12446 
  20. Karanges EA, Blanch B, Buckley NA et al. Twenty-five years of prescription opioid use in Australia: a whole-of-population analysis using pharmaceutical claims. British J of Clinical Pharmacology 2016; 82:255–267. DOI:10.1111/bcp.12937
  21. Peacock A, Bruno R, Cama E, et al. Jurisdictional differences in opioid use, other licit and illicit drug use, and harms associated with substance use among people who tamper with pharmaceutical opioids. Drug and Alcohol Review 2015; 34;611–622. DOI:10.1111/dar.12279. Accessed Feb 2017.
  22. Wilkins C, Prasad J, Wong K, Rychert M. Recent trends in illegal drug use in New Zealand, 2006–2013. Social and Outcomes Research and Evaluation, School of Public Health, Massey University; Auckland, 2014.
  23. Butler T, Boonwaat L, Hailstone S, et al. The 2004 Australian prison entrants’ blood-borne virus and risk behaviour survey. Australian and New Zealand Journal of Public Health 2007; 31.1:44–50 
  24. Wallace J, Temple-Smith M. Elements of a co-ordinated response. Chapter 20 in Dore G, Temple-Smith M, Lloyd A (eds). Hepatitis C an expanding perspective. 2009; IP Communications: Melbourne.
  25. Thein H, Dore G. Natural history of hepatitis C virus infection. Chapter 4 in Dore G, Temple-Smith M, Lloyd A (eds). Hepatitis C an expanding perspective. 2009; IP Communications: Melbourne.
  26. Ministry of Health. Work in progress for improving hepatitis treatment services in New Zealand. Available on http://www.health.govt.nz/our-work/diseases-and-conditions/hepatitis-c. Accessed January 2017.
  27. Kaan IA, Jones T, McCaughan GW. Have we significantly underestimated the capacity in the Australian health system to treat chronic hepatitis C infection in an interferon-free era? Internal Medicine Journal 2017; 47;3:269–74. DOI: 10.1111/imj.13262 
  28. Sievert W. Interferon-free treatment for HCV infection: are we on the road to elimination? Internal Medicine Journal 2017; 47;3:247–49. DOI: 10.1111/imj.13354
  29. Lauzon C. Surveillance of HIV and hepatitis C prevalence among attendees of needle exchanges throughout New Zealand. 2010. Masters of Public Health Thesis, University of Otago, New Zealand. 


The downloadable PDF version of this article is only available to subscribers.

To view this content please login or subscribe