Targeting Hepatitis C: Treatment as Prevention

Written by Sofia Bartlett (@SofiaRB_88), PhD Candidate, University of New South Wales

for the National Science Communication Challenge

Billions of dollars could be saved by developing targeted implementation strategies for the delivery of new Hepatitis C virus treatments (Image: Sofia Bartlett)

Billions of dollars could be saved by developing targeted implementation strategies for the delivery of new Hepatitis C virus treatments (Image: Sofia Bartlett)

According to Pareto’s principle, or the 80-20 rule, it is thought 80% of infectious diseases are spread by only 20% of people infected.

If we could identify and treat that 20%, would we prevent 80% of infections from occurring?

Researchers at The Kirby Institute are developing new methods for studying how diseases like Human Immunodeficiency Virus (HIV) and Hepatitis C virus (HCV) are transmitted among groups of people, to try and answer this question.

There are about 230,000 people infected with HCV in Australia and it is the leading cause of liver disease and liver transplantation globally.

This disease has a huge financial and health burden.

Being able to predict who is more likely to transmit an infection to others could save billions of dollars and help eliminate diseases faster

There’s still no vaccine, but HCV treatment has just been revolutionised by new drugs that achieve 95% cure rates in only a few weeks. They also have few side effects.

However, the new drugs cost $80,000 to treat just one person. It would cost $20 billion to treat everyone in Australia alone.

Identifying and treating the 20% of infected people who are more likely to pass the virus on to others could be the solution, which is known as Treatment as Prevention. However no method exists to identify infected people who are more likely to transmit an infection.

Expensive vaccines are not viable but without a vaccine elimination of HCV without targeted treatment strategies seems unlikely

Researchers at The Kirby Institute have developed a new identification method. Using the signatures in the virus’ genetic information, they can piece together the virus' spreading pathway in a population of people. Which allows them to see if some people are spreading the infection more frequently than others.

Their research has found that HCV is being transmitted frequently among people who are also infected with HIV, so this is a group of people that could benefit greatly from being treated with the new drugs.

The researchers at The Kirby Institute believe the new techniques they are developing could identify more potential targets for Treatment as Prevention for HCV. There is also the potential for the application of these techniques to diseases like HIV, ebola or the common cold. This would result in a much larger reduction in disease transmission, giving the best chance for eliminating these diseases and potentially saving billions of dollars in conventional treatments.

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