Return on investment in needle and syringe programs in Australia: report

3.5 Number of HCV infections prevented through the introduction of NSPs

Page last updated: 2002

3.5.1 Estimates of injecting drug users with HCV and HCV-related deaths with NSP introduction

Estimates and projections of the number of people living with HCV acquired through injecting drug use by disease stage and HCV-related deaths from 1961 through to 2075 with the introduction of NSPs are provided in Table 3.5.1 (in Appendix C). In 2000, the number of people living with HCV is estimated to be approximately 200,000 (approximately 150,000 with chronic HCV infection). By 2010 an estimated 11,800 people are projected to be living with cirrhosis, and estimated cumulative HCV-related deaths are projected to be 1,800.

3.5.2 Estimates of injecting drug users with HCV and HCV-related deaths without NSP introduction

Corresponding estimates and projections of the number of people living with HCV by disease stage and HCVrelated deaths without the introduction of NSPs are provided in Table 3.5.2 (in Appendix C). In 2000, the number of people living with HCV is estimated to be approximately 220,000 (approximately 165,000 with chronic HCV infection). By 2010 an estimated 12,500 people are projected to be living with cirrhosis, and estimated cumulative HCV-related deaths are projected to be 1,900.

3.5.3 Estimates of HCV infections and deaths prevented through NSP introduction

Estimates of the number of HCV infections and HCV-related deaths prevented through the introduction of NSPs (over the period 1988 through 2000) are provided in Table 3.5.3 (inAppendix C). By the year 2000, approximately 21,000 HCV infections are estimated to have been prevented since the introduction of NSP in 1988, (of which approximately 16,000 would have developed chronic HCV); while by 2010 approximately 650 fewer people are projected to be living with cirrhosis and 90 HCV-related deaths would have been prevented.

3.5.4 Estimates of HCV cases prevented by disease stage and diagnosis category

In Australia, an estimated 70% of people living with hepatitis C are diagnosed (NCHECR 2001). Table 3.5.4 outlines the estimates of diagnosed chronic hepatitis C by stage of liver disease. It was assumed that proportions of diagnosed chronic hepatitis C would increase with disease stage to reach 100% for advanced liver disease complications (HCC, liver failure).

Estimates of the number of HCV cases prevented through the introduction of NSP by disease stage and diagnosis category are provided in Table 3.5.5 (in Appendix C). These estimates form the basis for the calculation of the health care cost savings provided by the introduction of NSPs. Although there may be quality of life impairment and health care costs for people who are HCV antibody positive but do not have chronic hepatitis C, we have taken the conservative approach of basing our analyses on cases of chronic hepatitis C only.
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Table 3.5.4 Proportions of people with diagnosed chronic hepatitis C at different disease stages

Disease stageDiagnosed/Undiagnosed (%)
Mild chronic hepatitis C
60/40
Moderate chronic hepatitis C
75/25
Compensated cirrhosis
80/20
Liver failure
100/0
Hepatocellular carcinoma
100/0

Note: An estimated 70% (140,000/200,000) of people living with hepatitis C in Australia are aware of their HCV status (NCHECR 2001).