Getting ready for hep C treatment

MONA CHONG

Desdemona Chong is the Haemophilia Psychologist at the Royal Brisbane & Women’s Hospital

It is indeed an exciting and hopeful time for many who can now access new treatments for hepatitis C under the Pharmaceutical Benefits Scheme. The new treatment regimens promise a higher cure rate with minimal side-effects and short treatment durations – taking away many barriers for our community. It is important to be ready to take advantage of this opportunity.

1) What is the process like?
Hopefully you have already booked an appointment to see your hepatitis clinic! Talk to your Haemophilia Treatment Centre about a referral if you don’t know where to start. They might recommend that you get a 12-month referral from a GP to cover all of the visits for your treatment.
Moving forward with treatment, you will need to make time to attend appointments at the hepatitis clinic and pathology services to prepare for treatment, and monitor your progress and response. The number of visits you will need to make will depend on your individual health. People with no complicating factors won’t need many visits. Others will need to have more intensive monitoring and follow-up.
Overall, the feedback from people who are having treatment is that it is a reasonably straightforward and easy process.

2) How does this new treatment compare to previous interferon-based treatments?
The number of tests and appointments will depend on your liver health and other complications. Side effects, if any, are usually minor.
This means that compared to the previous interferon-based treatments, the length of treatment is shorter, there are fewer appointments and you are likely to be able to continue a normal life while on treatment.

3) How long is the course of treatment?
The new treatment courses are shorter – 8, 12, or 24 weeks. It depends on factors like your genotype, your liver health, whether you have had unsuccessful treatment in the past and other existing complications.

4) What does the treatment involve?
Medication for people with genotypes 1, 2 and 3 is now in tablet form. There are no injections. A small number of people with other genotypes may still need to have a combination treatment with interferon for a successful result.
Your treating doctor will also need to assess any other treatments you are on to see if they are compatible with the new hepatitis C treatments.

5) What about side effects?
There are few side effects and they are usually minor. They can include headache, nausea, diarrhoea, insomnia (sleeplessness), fatigue and, with ribavirin, anaemia. If you have any side effects – and many people don’t – remember to talk to your treatment team to get some help with managing them.
People on treatment have reported little psychological impact. If anything, you may just require some practical support, e.g. to get to appointments or to be reminded to take your medication.

6) What if I have some problems, e.g. difficulty getting to appointments?
Speak with your Haemophilia Treatment Centre to see if they can provide support or help to problem-solve any barriers preventing you from seeking treatment.

7) What can I do to maximise success?
Besides keeping to your medication schedule and attending all your appointments, it is also a good idea to reduce alcohol intake to get the best out of the treatment. Talk to your Haemophilia Treatment Centre if you have other concerns.

HELPING THE SYSTEM TO WORK

Because of the ease of treatment and the higher success rate, there are a lot of people waiting for treatment. It is important to be proactive about your appointments and keep them.

If you are unable to attend an appointment, let the clinic know in advance so that you can be rescheduled. Otherwise you run the risk of being removed from the system.

If you have not heard from the clinic for a couple of weeks, it is best to follow up with a phone call and check when your next appointment is.

It’s by everyone working together that we can make this a success for all.

Thanks to Dr Joe Sasadeusz, Infectious Diseases Specialist, and Megan Walsh, Clinical Nurse Consultant, Ronald Sawers Haemophilia Centre, from the Alfred hospital in Melbourne; and community members currently on treatment, for their helpful comments on this article.