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Eliminate C (EC) Victoria partnership

Past project

This project informed the design and implementation of the national Eliminate Hepatitis C (EC) Australia partnership.

Objective

The project aimed to:

  • support health services to increase hepatitis C virus (HCV) treatment uptake in people who inject drugs (PWID) using nurse-led models of care in primary care and prison services
  • assess the feasibility and impact of treating over 1,500 PWID annually in Victoria on prevalence and incidence of HCV in community and prison populations
  • inform HCV elimination models in Australia and globally.

Timeline

2016–2021.

Approach

EC Victoria used a partnership approach involving researchers, healthcare providers, policy makers, community organisations and drug user networks. There were 5 main components of EC Victoria:

  1. Increase demand through health promotion, including funding community partner organisations Harm Reduction Victoria and Hepatitis Victoria/LiverWELL to develop new and improved health promotion resources, and convening a EC Health Promotion Working Group to coordinate community activities. This included Fitpack stickers and Be Free From C - Getting Treated on the Outside booklet produced by LiverWELL with support from EC Victoria and  Hep C Treatment 'Ezy Card' Resource produced by Harm Reduction Victoria with support from EC Victoria.
  2. Increase clinical capacity through training & education, including delivering education and training sessions and mentoring healthcare providers to increase testing and DAA prescribing, FibroScan training & certification program and loaning agreement to increase FibroScan access in regional Victoria, and producing a series of clinical resources including a toolkit to streamline clinical pathways.
  3. Increase access to HCV testing & treatment through clinical support and streamlined clinical pathways in community and prison settings using nurse-led models: We partnered with 16 primary care services to implement enhanced HCV testing & treatment programs with EC nurses delivering a tailored package of support that included delivery of on-site pathology, point-of-care testing, incentives, FibroScans, treatment assessment and/or referrals and support to service staff to recall and follow up clients. Under the state-wide prison program led by St Vincent’s Hospital, EC Victoria supported the delivery of an HCV treatment program in 14 prisons, a trial of a care navigator program to link people released from prison into community based care and established a reporting mechanism for hepatitis C in prisons.
  4. Establish integrated HCV data and surveillance system to monitor trends in HCV prevalence and incidence over time, including expanding the ACCESS surveillance system to an additional 16 sites, and developing indicators to monitor the HCV care cascade at the service level.
  5. Research and evaluation to trial new interventions to increase uptake of HCV testing & treatment, including:
    • a trial of rapid point-of-care testing (Rapid-EC)
    • the EC Experience cohort to identify barriers and enablers to care
    • the Peer Assisting Treatment of Hepatitis C (PATH) project integrating peers into HCV models of care
    • a World Hepatitis Day 2019 campaign demonstrating the utility of incentives to reach new clients.

Community impact

EC Victoria: 

  • supported 16 primary care services to conduct 14,293 tests (antibody and RNA) and treat 1,342 people
  • supported 14 prison sites to conduct 2465 clinical assessments and treat 1,928 people. 

In total, approximately 3,270 PWID were treated for HCV over five years.

Many of the lessons and learnings from EC Victoria were used to inform the design and implementation of the larger, national EC Australia Partnership. Findings from EC Victoria implementation and research projects influenced several national and global policy and guidelines.   

Further evaluation of the EC Victoria components are being used to inform ongoing HCV elimination efforts in Victoria and other jurisdictions.

Burnet Logo Trademark Presentation (1)
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Photos of people involved in the hepatitis C partnership and research.
Photos of people involved in the hepatitis C partnership and research.
Posters about hepatitis C treatment. Developed as part of the partnership.
Posters about hepatitis C treatment. Developed as part of the partnership.
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Publications

09 Mar 2022

Health service utilisation and access for people who inject drugs during COVID-19.

Drug and alcohol review

Efunnuga H, Higgs P, Walker S, O'Keefe D

28 Jul 2021

Barriers to hepatitis C treatment among secondary needle and syringe program clients and opportunities to intervene.

The International journal on drug policy

Gunn J, McNally S, Ryan J, Layton C, Bryant M, Walker S, O'Mahony C, Pedrana A

12 Dec 2020

Increasing hepatitis C testing and linkage to care: Results of a testing campaign with incentives at primary care clinics in Melbourne, Australia.

Journal of viral hepatitis

Chan K, Elsum I, Gold J, Layton C, Accadia L, Bryant M, Gunn J, Djordjevic F, Purcell I, Dicka J

18 Mar 2021

A costing analysis of a state-wide, nurse-led hepatitis C treatment model in prison.

The International journal on drug policy

Palmer A, Papaluca T, Stoové M, Winter R, Pedrana A, Hellard M, Wilson D, Thompson A, Scott N, EC Victoria Partnership

30 Jun 2020

The impact of universal access to direct-acting antiviral therapy on the hepatitis C cascade of care among individuals attending primary and community health services.

PloS one

Traeger MW, Pedrana AE, van Santen DK, Doyle JS, Howell J, Thompson AJ, El-Hayek C, Asselin J, Polkinghorne V, Membrey D

14 Jan 2019

Outcomes of treatment for hepatitis C in prisoners using a nurse-led, statewide model of care.

Journal of hepatology

Papaluca T, McDonald L, Craigie A, Gibson A, Desmond P, Wong D, Winter R, Scott N, Howell J, Doyle J

01 Apr 2019

Community-based, point-of-care hepatitis C testing: perspectives and preferences of people who inject drugs.

Journal of viral hepatitis

Latham NH, Pedrana A, Doyle JS, Howell J, Williams B, Higgs P, Thompson AJ, Hellard ME

22 May 2019

Point-of-care hepatitis C testing from needle and syringe programs: An Australian feasibility study.

The International journal on drug policy

Williams B, Howell J, Doyle J, Thompson AJ, Draper B, Layton C, Latham N, Bramwell F, Membrey D, Mcpherson M

Partners

Funding partners

  • NH&MRC partnership grant with Gilead Sciences

Collaborators

  • St Vincent’s Hospital, Department of Gastroenterology (Alex Thompson and team)
  • Harm Reduction Victoria
  • Hepatitis Victoria/LiverWELL
  • Victorian Department of Health
  • Justice Health Victoria
  • Alfred Hospital

Project contacts

Main contacts

Associate Professor Alisa Pedrana

Associate Professor Alisa Pedrana

Senior Research Fellow; Deputy Discipline Head, Public Health; Eliminate Hepatitis C Australia Coordinator
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Project team

Dr Rebecca Winter

Dr Rebecca Winter

Deputy Head Justice Health Group
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Anna Palmer

Anna Palmer

Honorary Associate
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Associate Professor Alisa Pedrana

Associate Professor Alisa Pedrana

Senior Research Fellow; Deputy Discipline Head, Public Health; Eliminate Hepatitis C Australia Coordinator
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Dr Anna Wilkinson

Dr Anna Wilkinson

Research Fellow
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Dr Bridget Draper

Dr Bridget Draper

Senior Research Officer
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Dr Daniel  O'Keefe

Dr Daniel O'Keefe

Senior Project Officer
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Dr Imogen Elsum

Dr Imogen Elsum

Research Program Manager
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Professor Joseph (Joe) Doyle

Professor Joseph (Joe) Doyle

Deputy Program Director, Disease Elimination; Co-Head, Infectious Diseases Clinical Research; President, Hepatitis Australia; NHMRC Clinical Research Fellow
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Professor Margaret Hellard AM

Professor Margaret Hellard AM

Deputy Director, Programs; Adjunct Professor, Monash University, DEPM.
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Professor Mark A  Stoové

Professor Mark A Stoové

Head of Public Health
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Mellissa Bryant

Mellissa Bryant

Senior Researcher
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Dr Michael  Traeger

Dr Michael Traeger

Research Officer
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Professor Paul Dietze

Professor Paul Dietze

Program Director, Disease Elimination; Professor and Program Leader, National Drug Research Institute (NDRI)
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Associate Professor Peter Higgs

Associate Professor Peter Higgs

Principal Research Fellow; Honorary Associate Professor, Department of Public Health, La Trobe University
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Dr Joshua  Ginnane

Dr Joshua Ginnane

Public Health Registrar
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Tiffany Pe

Tiffany Pe

Research assistant
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