#71 HepSA Community News

#71 • October 2016

Community News

World Hepatitis Day 2016 New vs Old Treatment • Prison CNPs

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Hepatitis SA provides free information and education on viral hepatitis, and support to people living with viral hepatitis.

Street Address: 3 Hackney Road, Hackney

About the Front Cover: Paintings derived from photographs

by Lisa Carter.

Correspondence: Please send all correspondence to The Editor at PO Box 782, Kent Town, SA 5071, or email editor@ hepatitissa.asn.au.

Editor: James Morrison

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Contents

1 News 2

Heroes of Old Treatment

4

Councils Support WHD

HEPATITIS SA BOARD

6

SIN Pamper Packs

Chair Arieta Papadelos

7

Street Soccer

8

Quirky Delights

Vice Chair Bill Gaston Secretary Lindsay Krassnitzer Treasurer Sam Raven Ordinary Members Catherine Ferguson Ratan Gazmere Kirsten Hicks Nicci Parkin Kerry Paterson (EO) Sharon Jennings Jeff Stewart

10 James Nash House 11 Research at the RAH 12 Prison CNPs 15 What’s On 16 In Our Library Disclaimer: Views expressed in this newsletter are not necessarily those of Hepatitis SA. Information contained in this newsletter is not intended to take the place of medical advice given by your doctor or specialist.

We welcome contributions from Hepatitis SA members and the general public.

SA Health has contributed funds towards this program.

News

Hep C Drugs Led Economic Growth

Treasurer Scott Morrison revealed that Government spending on the new hepatitis C drugs led Australia’s economic growth in the last quarter.

Australia has had 25 years of continuous economic growth. Figures released on 7 September showed a 3.3% growth for the last quarter with Government spending the biggest contributor.

“The growth in new public final demand [an estimate of the level of spending in the local economy by the public sector] in the most recent quarter can be substantively attributed to the listing of the hep C drugs on the PBS,” the Treasurer stated.

PBAC approves Zepatier

The Pharmaceutical Benefit Advisory Committee has approved zepatier to be listed on the PBS in the near future.

Zepatier is a direct-acting antiviral drug, and will be used to treat hepatitis C genotypes 1, 4 and 6.

It is a once-daily, fixeddose combination tablet containing elbasvir and grazoprevir, a protease inhibitor, administered for 12 weeks.

Clinical trials showed that sustained virologic response (SVR) 12 weeks after the completion of therapy was achieved in 96% of patients who had chronic genotype 1b hepatitis C.

From these trials, the PBAC considered the evidence for using zepatier with genotype 1 was sufficient to establish safety and effectiveness.

For genotypes 4 and 6, the PBAC agreed there was a clinical need for treatment regimens that do not contain peg-interferon, and recommended zepatier for these genotypes.

More information will be given here and on our website as it becomes available.

Interpreting Hepatitis A show of appreciation from information session participants, and (below) an Auslan Interpreter at work The Bhutanese deaf community made history when they started Auslan classes at TAFESA as part of the Adult Migrant English Program—an Australia-wide first for TAFE. Learning the language enabled deaf Bhutanese to communicate with service providers via sign language interpreters instead of relying on gestures interpreted by relatives.

Taking advantage of this newly acquired language skill, the Bhutanese community organised a hepatitis information session for their deaf community as their World Hepatitis Day activity.

Four interpreters interpreted the presentation, on rotation, for the session which included some interesting questions, answers and sharing of stories.

October 2016 • HEPATITIS SA COMMUNITY NEWS 71

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Heroes of Old Treatment

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s part of World Hepatitis Day, people all over the world were encouraged to investigate the new treatments now available for hepatitis C. These treatments are more effective, faster, easier to take and with fewer sideeffects than the treatments which were used up until early 2016.

However, all the excitement about the new treatments has obscured one thing: just how much hardship people had to go through before this year to treat their hepatitis C—hardship that quite frequently didn’t even end up in the virus being cleared.

Until this year, hepatitis C treatment almost always consisted of “combination therapy”: a combination of pegylated interferon and ribavirin. The course of treatment was sometimes 24 weeks, but more usually 48 weeks. The interferon was self-injected once a week, and the ribavirin taken twice a day in capsule form.

Side effects from combination therapy could include nausea, depression, thyroid abnormalities, muscle aches, anaemia and hair loss. In addition, ribavirin is also associated

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with birth defects, so contraceptive use was essential for both men and women during and for a period after treatment— which could mean more than a year.

For some people, the physical and psychological side effects of combination therapy were overwhelming. Given that treatment could last for up to twelve months, some people found it hard to look after their children and impossible to work, and many people experienced difficulties in their personal and professional lives.

And after all that, only an average of 60% of people cleared hepatitis C: about 80% of those with genotypes 2 or 3, but only 50% with the most common form, genotype 1.

Carol Bose was one of many people hit by combination therapy’s side-effects. “A main concern for the specialist at that time was that for some people treatment can cause suicidal thoughts, and it was highly recommended that there was support from a partner or family for the duration of the treatment,” she told Hepatitis SA Community News in 2014.

HEPATITIS SA COMMUNITY NEWS 71 • October 2016

“[I was] drained all the time, as though I had just run a marathon—body aches and pains, headaches, some nausea, dry skin, dry mouth and hair loss. My hair started to thin so I got extensions, but it didn’t take long before they began to pull my hair out from the roots. I would spend most of my days lying on the sofa watching TV. “I remember leaning against the sink at night while brushing my teeth because it was too tiring to stand for long. My house wasn’t very big but I would have to sit down and take a break when walking from one side to the other.”

Carol was lucky enough to have the treatments work for her. Karan, one of Hepatitis SA’s Peer Educators, was not so lucky, though she still found the process empowering. “I had to pace myself, have days off to regain my strength. It wasn’t an easy road.”

After combination therapy failed her, Karan was accepted into a medical trial of the new treatments in 2013, which did succeed in clearing the virus.

Penny, another Hepatitis SA Peer Educator, simply didn’t go on treatment

because of the probable side-effects. “I simply cannot afford to give up my work. I work part-time, but I earn just enough not to be eligible for government assistance. If I had to cut my hours back, my income would drop significantly.”

One of the worst experiences was that of Kaz Dean, who documented her experiences with combination therapy in a video diary on Youtube (see Kaz’s video collection at bit.ly/2b5m9a2).

“I began interferon and ribavirin treatment at the Royal Adelaide Hospital. I had a negative experience right from the start—any side-effects that have been mentioned, I experienced them, and then some! I even had blackouts or the opposite of blackouts, a kind of hallucination or false memory, where I swore to my partner that we had had a night out the night before, and though the memories were so real to me, he told me we had gone nowhere.

“I was mentally affected, and physically I couldn’t function. There were quite a few times where

ambulances were called, due to my haemoglobin being so low: I kept passing out, and at one point had a fit at the doggy park, banging my head on the ground repeatedly.

“During my treatment the blood test results had come back with the virus undetectable a few times, so I had hope, but in the end I was bedridden and had to stop the treatment 10 weeks early. The outcome of that horror story was that no, I didn’t lose the virus, and I swore I would never go on the treatment again.”

So as we celebrate the efficacy and relative ease of the new treatments for hepatitis C, with even more effective treatments still on the horizon, let’s not forget all the difficulties and obstacles faced by those who faced treatment in the past, and those who made the hard decision to decline the opportunity of being treated because of its harshness. Without them and what they had to go through, there would not have been the impetus to develop new medications.

NOTE: As of February 2020 we have removed these images and their caption to avoid causing offence, as they depict and name an Indigenous person who has since died.

James Morrison

This piece first appeared on our new blog, HepSay, at hepatitissa.asn.au/blog. Come and visit us there!

October 2016 • HEPATITIS SA COMMUNITY NEWS 71

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Councils Support WHD

Mayors across Adelaide back Nohep

Nohep in the City of Adelaide Nohep in the North Nohep in the South Nohep in the East Nohep in the West …Nohep is best!

T

he Right Honourable Lord Mayor of Adelaide, Martin Haese, along with the friendly Mayor of Playford, Glenn Docherty, the delightful Mayor

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HEPATITIS SA COMMUNITY NEWS 71 • October 2016

of Onkaparinga, Lorraine Rosenberg, the charming Mayor of Norwood, Payneham and St Peters, Robert Bria, and the lovely Mayor of Charles Sturt Angela Evans, all met with O’Liver to help him promote World Hepatitis Day. Our focus for the day this year was the promotion of the new direct-acting antiviral treatments that became available in Australia at the beginning of March.

Call Us! Free, confidential information and support on viral hepatitis:

1800 437 222

The World Hepatitis Alliance “Nohep” campaign to make the elimination of viral hepatitis humanity’s next greatest achievement is the first Global Viral Hepatitis Campaign the world has ever seen.

With this campaign, the simple and effective new

treatments, help from O’Liver and our friends, we are well on track.

Get tested, get treated. We can eliminate hepatitis C by 2030.

Lisa Carter Coordinator - Outreach Hepatitis C Peer Education & Support Project

October 2016 • HEPATITIS SA COMMUNITY NEWS 71

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The women’s (left) and men’s (right) pamper packs

Info & Support Line • 1800 437 222

SIN Pamper Packs Raising awareness and wellbeing

Non-judgemental support and info on hep B testing and treatment

Knowledge is power!

S

A Sex Industry Network (SIN) staff put on a World Hepatitis Day activity that would pamper SIN clients and remind them to look after their health by getting vaccinated against hepatitis B and/or accessing the new hepatitis C treatments.

Hep B card - 2016 update.indd 1

13/07/2016 4:52:55 PM

SIN staff had the idea of providing clients of their sex shop and outreach services with a pamper pack; a bag chock-full of the things which make you feel special and which can be difficult to afford.

Hepatitis SA’s Information and Resources Team had previously developed an eye-catching business card with the statement

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‘You look beautiful today,’ on the front; the back of the card encouraged people to “prevent hep B; get vaccinated”.

Combining the pamper pack with the business card seemed a logical way to raise awareness of hepatitis B prevention amongst the sex worker community. But why not use the opportunity to raise awareness of the new hepatitis C treatments as well?

To do so, the still-screenshots from the ‘New vs.

Old Hep C Treatments’ film

by Hepatitis SA (see p3) were printed into a booklet which was added to the pamper pack.

HEPATITIS SA COMMUNITY NEWS 71 • October 2016

Other items included in the pamper pack were bath salts and lip balm, handmade locally, as well as shavers, body butter, nail polish and more.

A men’s pack was also produced which included a shaving gel.

Feedback from SIN was that the packs were really well received by the community. They literally walked out the door! Many clients said that it felt great to know that services cared about them and their needs. Lots of questions were asked about the new hep C treatments and where to access hep B vaccinations.

Street vs Dragons

bstacles and

W

orld Hepatitis Day isn’t just about information sharing and healthy eating. It’s about healthy activity, too.

The Big Issue Community Street Soccer team* and the Adelaide Dragons met for a friendly match on 27 * The Big Issue Community Street Soccer Program creates an opportunity for homeless, disadvantaged and marginalised people to improve their health and positively change their lives through sport.

pportunities

July as part of each team’s hepatitis awareness activity.

The Dragons, an all-girls soccer team from the Bhutanese community had an information and hepatitis C quiz before trooping to Stepney to play against the Street team which had their information and quiz after the game.

About 40-50 players and their supporters participated in the event.

October 2016 • HEPATITIS SA COMMUNITY NEWS 71

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Quirky Delights Delicious and healthy liver food

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e know too much sugar and fat puts a burden on our liver, and is bad for our health in general. So wouldn’t it be wonderful to enjoy a bowl of warm, creamy soup without feeling guilty about the fat and bite into a muffin without worrying about the sugar or the gluten, if you’re gluten-intolerant?

Over the years, due to a family member’s illness, Chris had, out of necessity, to discover alternative, healthier ways to making those delicious, rich foods which we love but which many feel guilty about eating.

A cooking display by Chris was the central event of Hepatitis SA’s World Hepatitis Day celebrations this year. Hosted by the Adelaide City Library, the filled-to-capacity demonstration included quick demonstrations on making almond milk, and instructions on how to make a range of extremely tasty treats and meals, with plenty of opportunities for tasting along the way. The broad principles of eating well for liver health were also covered by a Hepatitis SA educator.

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HEPATITIS SA COMMUNITY NEWS 71 • October 2016

Broccoli Salad • 250g Broccoli Florets • 1 Apple (quartered) • 30g of Nuts of choice (walnut, cashews, pine nuts or pecans) • 25g Olive Oil • 15g White Balsamic Vinegar • 1 teaspoon honey • 1.5 teaspoon of Dijon Mustard • ¼ teaspoon Herb Salt (or salt of choice) • ¼ teaspoon pepper or chilli flakes (optional) • ¼ cup of dried cranberries or sour cherries (optional) • Seeds of choice for garnish (optional) Add all ingredients except seeds and cranberries to food processor. Process until desired consistency is reached.

Stir through dried cranberries.

Sprinkle with seeds of choice (sunflower or pumpkin seeds etc) just before serving.

Gluten-Free Chocolate Bean Cake • 400g tin red kidney beans, drained and rinsed well • 1 tablespoon vanilla extract • 5 eggs • 1 tablespoon water or coffee • 70g unsweetened cocoa powder • 1/2 teaspoon bicarbonate of soda • 1 teaspoon gluten free baking powder (see next column) • 1/3 cup oil (or 125g butter, softened, if dairy is OK) • 1/4 teaspoon salt • 1/2 -3/4 cup raw sugar (according to taste) Preheat oven to 180⁰C.

Combine kidney beans, water, vanilla extract, oil and 1-2 eggs in food processor. Process until smooth and aerated.

Add remaining ingredients and process until well combined.

Pour batter into lined cake tin and bake for 20 minutes (cupcakes) and 30-40 minutes (for a 20cm cake) or until a toothpick inserted in the middle comes out clean.

Remove from oven and let cool slightly in tin before turning onto a cooling rack.

Gluten-Free Baking Powder • 2 parts Cream of Tartar • 1 part Bicarbonate of Soda • 1 part cornstarch Stir and sift all ingredients together. Store in airtight container.

All recipes © Chris Lim; all photos by Lisa Carter

An audience prize, this amazing hamper, was kindly donated by Foods for Life, Gawler Place ( foodsforlife.com.au) October 2016 • HEPATITIS SA COMMUNITY NEWS 71

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WHD @ JNH James Nash House celebrates Loving Our Livers

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n Wednesday, 10 August multiple healthy eating events were held across the wards at James Nash House (JNH) in recognition of World Hepatitis Day. Hepatitis SA supported JNH by providing new recipe ideas from the Eat Well for Your Liver book, which were used by residents and staff to prepare healthy lunches and snacks. Mango lassi, green smoothies and broccoli and beef stir-fry all proved popular.

The opportunity to think creatively and incorporating as many “liver loving foods” into new recipe ideas helped to promote healthy living and reflect on what we can each do to be kind to our bodies.

Hepatitis SA’s education team go to JNH every

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six weeks to talk to the residents in the different wards about hepatitis B and C transmission, prevention and treatment.

For the WHD event we wanted to focus more broadly on liver health.

The residents and staff were provided with shopping vouchers, the recipe books and the ‘12 things which are good for the liver’ and the ‘12 things which are bad...’ fact sheets before the event.

The residents participated by answering questions and naming foods. Peer educators Karan and Grant have both experienced hepatitis C treatments, old and new, and they spoke to the group about how easy the new hepatitis C treatments are and how the best thing you can do to look after your liver if you have hep C is to get it cured.

HEPATITIS SA COMMUNITY NEWS 71 • October 2016

We shared healthy snacks in the KOB ward and then went on to share lunch, prepared by residents and staff, with the Clare and Birdwood wards. To finish the day on a positive note and consolidate the learning, Hepatitis SA staff played a passthe-parcel game with residents where each person unwrapped a layer to uncover a question on something we had discussed during the event and a fruit bar. The person who unwrapped the final ‘layer’ won more fruit bars as well as some bliss balls and dried fruit.

We thank Claire, Karan, Gary and Grant for coming to share their knowledge and experiences with us.

Events like these help to grow awareness about hepatitis treatment, prevention, and just being good to our liver!

RAH to continue trials Public and professional outcry leads to backflip

M

inister for Health Jack Snelling has finally conceded that most researchers undertaking existing clinical trials, as well as new trials being planned, should be housed within the new Royal Adelaide Hospital (RAH) after all.

“Face-to-face patient consultations will continue to occur within the outpatient, inpatient or day treatment areas, as they do at the current RAH,” he said.

In addition, the South Australian Health and Medical Research Institute (SAHMRI) will accommodate some cancer and cardiology researchers, whose work aligns with the existing SAHMRI “research pillars”.

This backdown came after news broke in August that SA’s new state-of-the-art hospital would have no room for clinical trials. It was believed that, at best, only 15% of the 350 trials currently under way would be accommodated at the new RAH. In a letter to the media, Hepatitis SA Executive Officer, Kerry Paterson, pointed out that the RAH was the premier hospital in this state which ran the clinical trials that have led to this outstanding result for people with hepatitis C.

“In the three months [the new medicines] have been available, 1,200 South Australians have commenced treatment,” she said. “This figure—a tripling of the number of people treated in the previous year—represents 10% of South Australians living with hepatitis C. “It would be a tragedy if the new RAH could not find a way to accommodate these ongoing clinical trials in hepatitis C and allow the expertise of the clinical trials staff involved to continue to contribute to this success story for SA.” Hepatitis SA understands that the only solution initially offered by the Health Minister was to accommodate clinical trials administration in an existing building at the old RAH site, which is at the far end of North Terrace from the new RAH. In a letter to The Advertiser, past Head of Clinical Hepatology, RAH, Associate Professor Hugh Harley, and past Deputy Chair of Human Research Ethics Committee, RAH, Associate Professor Barry Chatterton, point out that the logistics of clinical trials mean they could not be conducted if patient care and research co-ordination are not on the same site where patients, doctors, research

staff and laboratories are located throughout the day.

“Any change to this will make future access to such clinical trials almost impossible,” they said, calling on the public and medical workers to contact the Health Minister with their concerns.

This campaign has been effective, with Executive Director New RAH Activation, Paul Lambert saying that they have been able to allocate space for nearly all researchers within the new RAH, with a small number utilising space in the SAHMRI next door.

“This is the result of extensive planning and will provide certainty for our research staff, clinicians and private research partners into the future,” he said.

Minister Snelling said worldclass research and clinical trials are vital to South Australia’s standing in the medical and research worlds.

“Having all our current clinical trials based in the heart of the Health and Biomedical Precinct, with the majority at the new Royal Adelaide Hospital, is an excellent outcome.

“These important trials will deliver potentially lifesaving medical breakthroughs for many years to come.”

October 2016 • HEPATITIS SA COMMUNITY NEWS 71

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Prison CNPs

This research paper is free, but a prison needle could cost you $350

P

rofessor Carla Treloar is head of the Centre for Social Research in Health’s hepatitis research team.

She recently published a paper entitled ‘The prison economy of needles and syringes: what opportunities exist for blood borne virus risk reduction when prices are so high?’ in PLOS ONE. (Read the paper in full at tinyurl.com/Treloar-prison).

Here she explains how the research took shape, and what it revealed.

A formal Needle and Syringe Program (NSP) is not provided in any Australian prison.

Injecting equipment circulates in prisons as part of an informal and illegal economy.

My co-authored paper examined how this economy generates bloodborne virus risk and risk

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mitigation opportunities for inmates.

Sometimes a paper comes along from nowhere or an idea keeps bugging you and you can’t leave it alone.

That’s what happened with this paper. The price inmates paid for “sterile” needles in prison was not on my mind when I designed the interview schedule for a project about managing hepatitis C risk in prison. But, in the first few interviews, the participants spontaneously mentioned how much they had paid for “sterile” and “used” equipment, and it was so fascinating, we decided that we couldn’t ignore it.

To put the price into perspective, we need some benchmark (and I’m grateful to one of the anonymous reviewers

HEPATITIS SA COMMUNITY NEWS 71 • October 2016

of the paper for pointing this out). Those with experience of the drug use sector would probably recognise $50 as a pretty common price for a single dose of heroin*. So to hear participants report prices in the range of $50-$350 for a single needle/syringe inside prison made our hair curl. Prices were cheaper for needles “for rent”, somewhere around $40.

So, that old movie cliché of “follow the money” screamed out from these data.

How did participants find equipment to sell or to buy? How did they pay for * This is also reported in this recent paper: Stafford J, Breen C (2016) Findings from the illicit drug reporting system (IDRS).

Sydney: National Drug and Alcohol Research Centre, UNSW, Australia

it? And, when prices are so high, were there any opportunities afforded by this black market economy to reduce hepatitis C risk?

Well, when prices are so high there is an intrinsic motivation to be on the winning side of it. You might be surprised, but there were few opportunities to reduce BBV risk in this economy.

Obviously, having money and the resources to import or purchase equipment is protective. Having awareness and means to exploit opportunities is important (such as when the prison is “flooded” with needles during mass vaccination programs).

So what would happen to this economy if a prison NSP was introduced? There are a few countries sensible and humane enough to provide prison NSPs. As far as we know, there hasn’t been any investigation into how a formal NSP disrupts or changes up the black market economy.

Prison Health No CNPs inevitably means more BBVs

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risons provide one of the most significant opportunities to drive down the prevalence of hepatitis C, and help reach global WHO elimination goals, says new research presented at the5th International Symposium on Hepatitis Care in Substance Users in September.

“On the downside, it is clear that prisons act as incubators of hepatitis C, driving the epidemic both within the prison system and in the community at large,” said Professor Andrew Lloyd of the University of New South Wales who leads hepatitis research in Australia’s prison system.

“On the plus side, they also offer a unique environment to cure people of the disease and address the risk behaviour that fuels transmission. If we can turn prisons around, and use them to treat hepatitis C rather than facilitate its spread, then we can save lives, reduce the overall burden of disease and take concrete steps towards disease elimination.”

Hepatitis C affects up to 103 million people around the world, resulting in around 700,000 deaths per year. The World Health Organisation (WHO) has prioritised the disease,

»

There has been one qualitative study of inmates’ perceptions and experiences of prison NSP, and some inmates express reservations about prison NSP: about coming to the attention of prison authorities by virtue of being a client of a prison NSP—so, again, prohibition drives everything before it.

Professor Carla Treloar

October 2016 • HEPATITIS SA COMMUNITY NEWS 71

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» setting ambitious targets to reach elimination by 2030.

In high-income countries like Australia, 80% of new infections are in people who use drugs. Prisoners have a particularly high prevalence of hepatitis C, reflecting the fact that imprisonment and injecting drug use are closely linked. This high prevalence means that use of non-sterile injecting equipment whilst in prison carries a high risk of transmission.

A new modelling analysis—presented at INHSU 2016 and led by Professor Peter Vickerman at Bristol University’s Division of Global Public Health—looked at hepatitis C transmission in scenarios mimicking four global settings: Australia, Scotland, Ukraine and Thailand. It found that prison could contribute massively to overall HCV transmission, whereas introducing prevention programs in prison and amongst individuals transitioning back to

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the community could significantly reduce these infections. The study is published as part of a recent Lancetcommissioned report on drugs and health.

Additional modelling studies in the UK have also shown that treatment with new highly effective therapies could also have a substantial impact, and could be cost-effective if continuity of care is ensured.

“It is clear from our modelling that incarceration is a very important driver of HCV transmission in many settings. It is unlikely that it will be controlled without focusing prevention and control measures on incarcerated individuals and those being released from prison,” said Professor Vickerman.

So far, Australia is one of the only countries to look at the mass scaleup of new hepatitis C treatment combined with prevention programs in

HEPATITIS SA COMMUNITY NEWS 71 • October 2016

a prison setting. Health experts at INHSU 2016 say the evidence indicates it is now time for other countries to follow their lead.

“The high level of mobility between prison and the community means that the health of prisoners should be a major public-health concern,” said President of the International Network of Hepatitis C in Substance Users (INHSU), Associate Professor Jason Grebely of Australia’s Kirby Institute.

“Scaling up harm reduction programs and introducing testing and treatment strategies could potentially reduce and even reverse hepatitis C transmission and help us reach the WHO elimination goals. Yet, screening and treatment for hepatitis C is rarely made available to inmates.

If we are serious about treating this disease, we need to seize the opportunity prisons present and make testing, treatment and prevention in this setting a priority.”

Affected by hepa

Affected by hepatitis C? Photo © S. Allen

Calming the C 2016 Dates

Calming the C: Hackney

• Information and support in a confidential, 12.30–2.30pm Hepatitis SA, 3 Hackney Rd, Hackney friendly environment Tuesday, 13 September Tuesday, 19 January Tuesday, 10 May Tuesday, 27 September Tuesday, 24 May • Speak to others who have had treatment Tuesday, 2• February Partners, family and friends welcome Tuesday, 16 February Tuesday, 1 March Tuesday, 15 March Tuesday, 29 March

Tuesday, 7 June Tuesday, 21 June

Tuesday, 11 October Tuesday, 25 October

Tuesday, 5 July Tuesday, 19 July

Tuesday, 8 November Tuesday, 22 November

2016 Dates

Calming the C: Hackney Now12.30–2.30 meeting at HACKNEY, ELIZABETH pm Hepatitis SA, 3 Hackney Rd, Hackney Tuesday, 6 December Tuesday, 12 April Tuesday, 2 August Tuesday, Tuesday, May Tuesday, 20 13 December September ADELAIDE Tuesday, 10 16 August Tuesday, Tuesday, 19 26 January April and PORT Tuesday, 24 May Tuesday, 27 September Tuesday, 30 August information, phone 8362 8443 Tuesday, 2For February Tuesday, 16 February June Tuesday, 11 October SeeTuesday, over721for Tuesday, Junedates Tuesday, 25 October

CALMING the C in the NORTH 2016 Dates

Tuesday, 1 March Tuesday, 15 Tuesday, 5 July 16 Playford Tuesday, November 1–3 pmMarch RoomC20, GP plus Elizabeth, Blvd, 8Elizabeth Tuesday, 29 March Tuesday, 19 July Tuesday, 22 November Thursday, 21 January Thursday, 12 May Thursday, 1 September Thursday, 18April February Tuesday, 12 Tuesday, 26 April Thursday, 17 March

Thursday, June Thursday, September Tuesday, 29August Tuesday, 629 December Tuesday, 16 August Tuesday, 20 December Thursday, 7 July Thursday, 27 October Tuesday, 30 August 12.30–2.30 pm Hepatitis SA, 3 Hackney Rd, Hackney24 November Thursday, 14 April Thursday, 4 August Thursday, Tuesday, 13 September Tuesday, 19 January Tuesday, 10 May Tuesday, 24 May Tuesday, 27 September Tuesday, 2 February Tuesday, 11 October Tuesday, 16 February Tuesday, 7 June 1–3pm RoomC20, GP plus Elizabeth, 16 Playford Blvd, Elizabeth Church St &Tuesday, Dale St, 25 Port Adelaide 12–2pm Wonggangga Turtpandi, Tuesday, cnr 21 June October Thursday, 21 January Thursday, 1 September Thursday, 12 May Tuesday, 1 March Tuesday, 23 August Tuesday, 3 May Tuesday, 12 January Tuesday, November Tuesday,18 15 February March Tuesday, 59July Thursday, Thursday,820 29 September Thursday, June Tuesday, September Tuesday, Tuesday, February Tuesday,9 29 March Tuesday, 31 19 May July Tuesday, 22 November Thursday, 17 March Thursday,18 27October October Thursday, 7 July Tuesday, Tuesday, 28 June Tuesday, 8 March Tuesday, December Tuesday,14 12 April April Tuesday, 24August Tuesday, November Thursday, Thursday,615 24 November Thursday, August Tuesday, Tuesday, April Tuesday,5 26 April Tuesday, 26 16 July August Tuesday, Tuesday,20 13December December Tuesday, 30 August

Calming the C: Hackney

CALMING the CALMING theCCinatthe the NORTH PORT

CALMING the C at the PORT 12–2 Wonggangga Turtpandi, cnr Church St & Dale St, Port Adelaide CALMING Tuesday, the 3CMayin the NORTH Tuesday, 23 August Tuesday, 12 January pm

Hepatitis C peer educators are also available to provide information and support to clients at the following services:

DASSA Central Services Hepatitis C Treatment Clinic 91 Magill Rd, Stepney Tuesdays 9–12am DASSA Central Pharmacy Thursdays Calming the C: Hackne 9–12am • Information and support in a

Calming 2016 Dates

12.30–2.30pm Hepatitis SA, 3 Hackney Rd, environment Tue Tuesday, 19 Januaryfriendly Tuesday, 10 May DASSA Southern Service Tuesday, 24 May • Speak to others who haveTue h Tuesday, 2 February 82 Beach Rd,• Partners, family and friends w Tuesday, 16 February Tue Christies Beach Tuesday, 7 June Tuesday, 21 June Tue Monday monthly Tuesday, 1 March Tue Tuesday, 15pm March Tuesday, 5 July 10am–1 Tuesday, 19 July Tue Tuesday, 29 March Upcoming dates:

2016 Dates

Calming Hackne Now meetingtheat C: HACKNEY

12.30–2.30 pm Hepatitis 3 Hackney Rd, Ring12 Lisa 84432SA, Tue Tuesday, Aprilon 8362 Tuesday, August Tue Tuesday, 19 January Tuesday, 10 May and PORT ADELA for details Tuesday, 16 August Tue Tuesday, 26 April

Tue Tuesday, Tuesday, 24 30 May August Tuesday, 2 February Tuesday, 16 February Service Tuesday, 7 June Tue DASSA Northern Tuesday, 21 June Tue 22 Langford Dr, Elizabeth Tuesday, 1 March Thursday fortnightly Tue Tuesday, 15 Tuesday, 5 July 16 Playford 1–3 pmMarch RoomC20, GP plus Elizabeth, 10 am –12 pm Tuesday, 29 March Tuesday, 19 July Tue Thursday, 21 January Thursday, 12 May Thu

For information, phone See over for dat

CALMING the C in the 2016 Dates Upcoming dates:

Thursday, 18April February Thursday, June Thu Tue Tuesday, 12 Tuesday, 29August Ring 26 Lisa on 8362Tuesday, 8443 16 August Tuesday, April Tue Thursday, 17 March Thursday, 7 July Thu for details Tuesday, 30 August SA, 34Hackney Thursday,12.30–2.30 14 April pm Hepatitis Thursday, August Rd, Hack Thu Tuesday Tuesday, 19 January Tuesday, 10 May Tuesday, 24 May Tuesday Hutt Street Centre Tuesday, 2 February 258 Hutt St, Adelaide Tuesday Tuesday, 16 February Tuesday, 7 June 1–3pm RoomC20, GP plus Elizabeth, 16 Playford Wednesday weekly Turtpandi, cnr Church St & Da 12–2pm Wonggangga Tuesday, 21 June Tuesday Thursday, 21 January Thursday, 12 May Thu Tuesday, 1 March 10am–12.30 pm Tu Tuesday, 3 May Tuesday, 12 January Tuesday Tuesday, 15 March 5 July9 June Thursday, 18 February Tuesday, Thursday, Thu Tu Tuesday, 31 May Tuesday Tuesday, February Tuesday, Tuesday, 299March 19 July Thursday, 17 March Thursday, 7 July Thu Tu WestCare Centre Tuesday, 28 June Tuesday, 8 March Tuesday Tuesday, 12 April Tuesday, 2 August Tu Thursday, 14 April Thursday, 4 August Thu 17 Millers (offTuesday, Wright 26 July Tuesday Tuesday, AprilCourtTuesday, Tuesday, 265April 16 August Tu St), Adelaide Tuesday, 30 August

Calming the C: Hackney

CALMING the CALMING theCCinatthe the

Wednesday weekly 10.30 am–12.30pm Wonggangga Turtpandi, cnr Church St & Da 12–2pm

CALMING the C at the CALMING theTuesday, C 3inMaythe NTu Tuesday, 12 January

1–3pm RoomC20, GP plus Elizabeth, 16 Playford Blvd pm RoomC20, GP plus Elizabeth, 16 Playford Blvd, Elizabeth has 1–3 been discontinued due to low attendance.

Tuesday, 20 September Tu Thursday, 21 January Thursday,31 12May May Thursday, 1 September Thursday, 12 May Tuesday, Tuesday, 31 May Thursda Tuesday, 9 February Tuesday,219 January February Thursday, Tuesday, 18 October Tu Thursday, 29 September Thursday, 18 February Tuesday, Thursday,28 9 June Thursday, Thursday, 9 June June Tuesday, 28 June Thursda Tuesday, 8 March Tuesday,188 February March Tuesday, 15 November Tu Thursday, 17 March Thursday,26 7 July Thursday, 27 October Thursday, 175 March Thursday, 7 July26 July Thursda Tuesday, July Tuesday, 5 April April October 2016 Tuesday, • HEPATITIS SA COMMUNITYTuesday, NEWS 71 15 Tuesday, 13 December Tu Thursday, 24 November Thursda Thursday, 14 April Thursday, 4 August Thursday, 14 April Thursday, 4 August

Tests & Procedures

Although we have a specialist library at Hepatitis SA (with a collection of hard copy books, DVDs, CDs etc.) our main collection is online. We now provide links via our catalogue to more than 1000 resources that are free to access via the internet.

If you have any problems with accessing these resources you can contact us and we will endeavour to provide a printed copy for loan. So… if you find a resource in our catalogue and are unable to download it please ring or email us with the details (ph: 8362 8443 or admin@hepsa.asn.au) In this issue we focus on the types of tests that are available, the processes involved and what the results may mean…

Liver function tests Patient information Publications & Egton Medical Information Systems, Leeds, 2015 bit.ly/lft_translations Gives a brief outline of what chemicals are measured in liver function tests, what these chemicals do, what test results may mean and what the tests are used for. Also gives a brief outline of what other tests may be recommended. Patient information provided at this site is also available in a range of different languages.

Antenatal testing and bloodborne viruses (BBVs) 2015 ASHM, Canberra, 2015 bit.ly/antenatalbloodtests_bbvs Aimed at health professionals providing women with antenatal care, this resource contains advice about recommended antenatal testing for the three major blood-borne viruses (BBVs): hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV).

Also provides information about the management of these BBVs during pregnancy and at delivery.

Fibrosis scan: what is it, and how will it help me?

Hepatitis SA, Adelaide, 2015 bit.ly/fibroscan_hepsa Gives details of the entire fibroscan process explaining exactly what will happen, what the tests measure and what the results may mean.

What is ALT? Hepatitis C Support Project, San Francisco, 2015 bit.ly/whatis_alt An overview of what alanine aminotransferase (ALT) is and what testing for ALT can determine.

Hep C testing infographic Hepatitis NSW, Sydney, 2016 bit.ly/testingflowchart An easy-to-read flow chart showing the range of tests that may be needed before going on treatment How to interpret (and understand) liver tests Hepatitis C Support Project, San Francisco, 2015 bit.ly/interpret_liver_tests Factsheet designed to give brief information about a range of tests, what they measure and what the results may tell you.

If you would like to know more about our library, please contact us at hepatitissa.asn.au/library, on 8362 8443 or email librarian@hepsa.asn.au.

16

HEPATITIS SA COMMUNITY NEWS 71 • October 2016

Useful Services & Contacts Hepatitis SA Free education sessions, printed information, telephone information and support, referrals, clean needle program and library.

(08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au Hepatitis SA Helpline 1800 437 222 (cost of a local call) Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card.

Call Hepatitis SA on 1800 437 222 for a referral. beyondblue Mental health information line

Lifeline National, 24-hour telephone counselling service.

SA Sex Industry Network Promotes the health, rights and wellbeing of sex workers.

13 11 14 (cost of a local call) www.lifeline.org.au

(08) 8351 7626

Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers.

13 14 65 MOSAIC Counselling service For anyone whose life is affected by hepatitis.

(08) 8223 4566 Nunkuwarrin Yunti An Aboriginal-controlled, citybased health service with clean needle program and liver clinic.

SAMESH South Australia Mobilisation + Empowerment for Sexual Health www.samesh.org.au Youth Health Service Free, confidential health service for youth aged 12 to 25.

Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100 Vincentian Centre Men’s night shelter run by St Vincent de Paul Society.

Assistance hotline: 1300 729 202

1300 224 636 www.beyondblue.org.au

(08) 8406 1600

Clean Needle Programs in SA For locations call the Alcohol and Drug Information Service, or visit the Hepatitis SA Hackney office.

P.E.A.C.E. HIV and hepatitis education and support for people from nonEnglish speaking backgrounds.

1300 131 340

(08) 8245 8100

Community Access & Services SA Alcohol and drug education; clean needle program for the Vietnamese and other communities.

Viral Hepatitis Community Nurses Care and assistance, education, streamline referrals, patient support, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for an appointment.

(08) 8447 8821

Central

headspace Mental health issues are common.

Find information, support and help at your local headspace centre

North

1800 650 890 www.headspace.org.au

Margery - 0423 782 415 margery.milner@health.sa.gov.au Jeff - 0401 717 953 Lucy - 0401 717 971 Trish - 0413 285 476 South

Rosalie - 0466 777 876 rosalie.altus@fmc.sa.gov.au Emma - 0466 777 873

Are you interested in volunteering with Hepatitis SA? Give us a call on 8362 8443 or drop us a line at admin@hepatitissa.asn.au.

We rely on volunteers for many of our vital services.

HEP C & HEP B WORKFORCE TRAINING! Do you know where to refer clients living with viral hepatitis? Do you know if there is a cure? Do you worry about blood exposure and needle-stick injury?

Sessions cover a range of topics, including: • Basics about hepatitis A, B and C • Transmission risks/myths • Best practice around blood and blood exposure • Discrimination • Lived experience from the perspective of a Positive Speaker • Any other topics relevant to your workplace!

Cost:

Free

Time:

1-2 hours

Where: In-service: we will come to you!

Contact the Education Team on 8362 8443 or email education@hepsa.asn.au