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Outcomes for Indigenous and non-Indigenous patients who access treatment for hepatitis C in the Top End of the Northern Territory

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To the Editor: Chronic hepatitis C virus (HCV) infection affects over 225 000 Australians1 and is a leading cause of the need for liver transplantation and of liver-related death, but curative treatments are available. Ethnicity is a major determinant of treatment responsiveness, with the lowest sustained virological response (SVR) rates reported in African patients, and the highest in Asian patients.2 Much of this difference is accounted for by racial differences in polymorphisms in the interleukin-28B (IL28B) gene;3 however, it is unknown how common these polymorphisms are in Indigenous Australians, and no studies have been published about hepatitis C treatment outcomes among Indigenous Australians.

The hepatitis C treatment service for the Top End of the Northern Territory is run from a community-based sexual health clinic in Darwin. As clinicians working at this service, our perception was that Indigenous people rarely accessed the service or received treatment for HCV infection. Further, we were concerned that — due to social, cultural and linguistic barriers — Indigenous people who accessed the service may be less likely to commence treatment and to successfully complete treatment and achieve an SVR. Following ethics…