Kerri-Ann Smith ... "People think hepatitis C equals drug use." Photo: Simon Alekna
April 15, 2012
WHEN healthcare worker Kerri-Anne Smith started feeling constantly exhausted, she put it down to being a single mother raising four children while working and studying.
It was only during a course on blood-borne viruses that Ms Smith, from Toongabbie, west of Sydney, suspected she might have contracted an infection from a blood transfusion many years earlier.
She saw her doctor and her suspicions were proved correct: she had contracted hepatitis C, a slow-acting virus that can cause severe liver damage.
Two new treatments, approved by the Therapeutic Goods Administration this year and described as a medical breakthrough will give hope to patients such as Ms Smith, who was devastated by her diagnosis in 1994, 10 years after her blood transfusion.
''I was really shocked. I went to pieces, actually, and I felt I couldn't tell anyone,'' she said.
The stigma of having a condition closely associated with intravenous drug use was almost as bad as the symptoms, Ms Smith said, which included extreme fatigue and aches and pains.
''I had four small children and lived in a small community,'' she said. ''I didn't want anyone to know. I didn't want the kids being told that they couldn't have friends over to play. I hid it for the first eight years. There is a lot of ignorance about how it is transmitted.
''People think hep C equals drug use. I call it discrimination by assumption.''
Hepatitis C is often called the silent epidemic. It can take up to 15 years after infection for its sufferers to show any symptoms.
Ms Smith feared liver disease might also be her fate. She suffered from the hepatitis C strain genotype-1, the most common form of the disease in Australia and the hardest to treat.
It accounts for about half of hepatitis C cases but does not respond well to standard therapy.
The TGA has approved two new drugs, boceprevir and telaprevir, for people suffering genotype-1. They belong to a new class of medicine known as direct-acting antivirals, which work by preventing the hepatitis C virus from replicating in people with genotype-1.
Treatment takes about half the time of standard therapy and has a cure rate of up to 80 per cent.
Ms Smith was one of the first people in Australia to undergo treatment as part of a trial at Westmead Hospital with telaprevir and says that while the side effects, which included depression and skin rashes, were unpleasant, it was worth it.
''The side effects were a small price to pay if it meant not dying from end-stage liver disease.''
A price has not been set for the two treatments in Australia and both drugs are awaiting listing on the Pharmaceutical Benefits Scheme.
In the US, a course of treatment costs between $US48,000 and $US85,000 ($46,000 to $82,000), according to the medical news service MedPage Today. But the chief executive of Hepatitis NSW, Stuart Loveday, believes the treatments are cost effective.
''It's far more economical to fund treatment for those people who need it and will benefit from it rather than allow them to progress to severe liver disease,'' Mr Loveday said.
''That will be an even greater burden down the track on Australia's healthcare system. The cost of a liver transplant is about $130,000. That's just for the operation. Then there is an annual maintenance cost of about $15,000 per year.''
Professor Geoff McCaughan, the head of the liver immunobiology program at the Centenary Institute and director of the AW Morrow Gastroenterology and Liver Centre in Sydney, said the two new treatments were the first in a whole series of direct-acting antiviral medication.
''It is a major breakthrough,'' he said.
''They are the first stepping stone in a whole swag of new drugs which are in the pipeline. They will focus on shorter duration of therapy which can help people with all genotypes of hepatitis C.''
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