The following groups should be considered for hepatitis C testing:

  1. People who inject drugs: Sharing needles or other injecting equipment is a major transmission route.
  2. Recipients of blood transfusions or organ transplants before 1990: Before widespread screening of blood supplies began.
  3. People with tattoos or piercings: Especially if done in unregulated settings.
  4. Individuals with a history of incarceration: Higher risk due to potential for unsanitary conditions.
  5. Immigrants from high-prevalence countries: Certain regions, particularly parts of Africa and Asia, as well as some European countries have higher rates of hepatitis C.
  6. HIV-positive individuals: Co-infection rates are significant.
  7. Children born to hepatitis C-positive mothers: Perinatal transmission, though less common, can occur.

Testing and early diagnosis are vital because hepatitis C often remains asymptomatic until advanced liver disease develops. Early diagnosis and thus treatment can prevent complications such as cirrhosis, liver cancer, and liver failure. Moreover, with highly effective antiviral treatments now available, achieving a cure is possible for most individuals, thereby halting disease progression and reducing transmission. Testing is via hepatitis C antibody, and if positive, hepatitis C PCR to confirm infection.

In people who have had hepatitis C previously and have self cleared it or had curative therapy, hepatitis C antibody testing is positive lifelong, so, if reinfection is suspected, hepatitis C PCR testing should be performed. Hepatitis C antibody (or PCR) testing should be performed annually in people who have ongoing risk factors for infection/reinfection.

The incidence of hepatitis C in Australia has been declining due to effective public health interventions, but new infections still occur. In 2019, the rate of new infections was 0.5 per 100,000 population. Despite this progress, continued efforts are necessary to reach elimination targets.

The 2024-25 federal Budget has allocated $23.7 million over two years to combat hepatitis B and C. This includes $7.8 million for hepatitis B pilot projects, $6 million for hepatitis C initiatives, and $9.9 million to expand hepatitis C point of care testing. Additionally, Hepatitis Australia will receive funding to lead national efforts towards eliminating hepatitis B and C as public health threats by 2030.

These investments underscore the government’s commitment to addressing hepatitis C, enhancing testing and treatment access, and ultimately improving health outcomes for affected Australians.