Key Terms

A

Alanine transaminase (ALT) – An enzyme found in the liver that helps turn proteins into energy for the liver cells. When the liver is damaged, for example by hepatitis C, ALT is released into the bloodstream, increasing levels of it in the body; see ‘Liver enzymes’.

Antibody test – An antibody is a protein produced by the immune system when it detects and tries to overcome an infection. An antibody test is a blood test used to identify exposure to hepatitis C. A positive antibody test shows that exposure to hepatitis C has occurred, but not whether hepatitis C is still in the body. The presence of hepatitis C is determined with a PCR test; see ‘Hepatitis C RNA (Ribonucleic Acid) PCR test (Polymerase Chain Reaction)’. After cure an antibody test can still detect hepatitis C antibodies but this does not mean that hepatitis C is still present.  

Aspartate transaminase (AST) – An enzyme that helps the body process amino acids. When the liver is damaged, for example by hepatitis C, AST is released into the bloodstream, increasing levels of it in the body; see ‘Liver enzymes’.

C

Cirrhosis of the liver – Scar tissue in the liver caused by inflammation of liver cells. The scar tissue reduces blood flow through the liver. The liver then can’t do its work as well as it should. Cirrhosis of the liver can be caused by a range of issues including hepatitis C.

Clearance – When the body clears the hepatitis C virus without treatment. Unlike a hepatitis C ‘cure’, which generally refers to curing the virus with treatment, spontaneous clearance occurs without any intervention. Spontaneous clearance usually occurs fairly soon (within six to 12 months) after acquiring the virus. Approximately 25% of people infected with hepatitis C spontaneously clear the virus (see also Spontaneous Hepatitis C Clearance).

Commonwealth Disability Support Pension – An Australian Government income support payment for people with permanent physical, intellectual or mental health conditions that prevent, or limit, access to paid employment. 

Commonwealth Newstart Allowance – An Australian Government income support payment for people who are unemployed.

Commonwealth Parenting Payment – An Australian Government income support payment for people who are the primary carers of a young child.

Compassionate access – The release of a medication prior to marketing approval by the Australian Therapeutic Goods Administration (TGA). Compassionate access programs make a treatment available to people before it has been listed on the Pharmaceutical Benefits Scheme by participating in research such as clinical trials. Compassionate access to direct-acting antiviral hepatitis C treatment started in Australia in 2012. The new treatment has been available since 2016 via the Pharmaceutical Benefits Scheme, but compassionate access is still available in certain circumstances for people who are not eligible for Medicare.

D

Direct-acting antiviral – The current form of hepatitis C treatment. The treatment is taken in tablet form, with around 95% of people cured on completion. Different kinds of tablets are used in combinations chosen to treat different hepatitis C genotypes. The treatment is effective for people with no liver damage as well as those who have some damage or cirrhosis. There are no restrictions on who can have hepatitis C treatment in Australia. Treatment is available to anyone with a Medicare card. 

G

Gastritis – A collection of health conditions that cause inflammation of the lining of the stomach. Gastritis can be the result of regular consumption of alcohol or certain pain medications. For most people, gastritis isn’t serious and can improve with treatment, but if left untreated it can lead to ulcers and heightened risk of stomach cancer.

Gastroscopy – A medical procedure where a thin, flexible tube called an endoscope is used to look into the oesophagus, stomach and first section of the small intestine. A gastroscopy is often used to investigate problems swallowing, stomach pain or ulcers and reflux.

H

Haemophilia – An inherited bleeding disorder where the blood doesn’t clot properly. It is caused when blood does not have enough of a protein or ‘clotting factor’. It is treated by infusing the missing factor, in the form of protein purified from human blood plasma or from synthetic sources.

Hepatitis C – A viral infection that affects the liver. People can live with hepatitis C for many years without symptoms. However, without treatment, hepatitis C can cause serious liver problems and sometimes liver cancer. Tablet-based medications also called ‘direct-acting antivirals’ are available and are highly effective.

I

Interferons – A group of proteins that act as part of the human immune system. Interferons trigger immune cells that attempt to stop viruses multiplying in the body. Past forms of hepatitis C treatment included interferons but these were associated with significant side effects and were much less reliable than the new treatment called ‘direct-acting antivirals’ (DAA).

Liver enzymes – Proteins that speed up chemical reactions in the body. A higher-than-average level of liver enzymes in the blood can indicate liver damage, and could be due to hepatitis C.

M

Methadone (Biodone®) – A prescription opioid medication that can be prescribed for pain and as an opioid pharmacotherapy treatment (methadone maintenance treatment or MMT); see ‘Opioid pharmacotherapy treatment’. Methadone maintenance treatment can prevent opioid withdrawal and help people cut down or stop taking other opioids. Available as a syrup, methadone can have sedative effects and relieve pain, but effects vary from person to person and depend on the context of consumption. Methadone is legal in Australia if prescribed or administered by a doctor. It is illegal to take methadone without a prescription, or to give or sell it to other people.

N

Needle and syringe program (needle exchange) – A public health initiative to provide new injecting equipment to people who inject drugs. Needle and syringe programs vary between states, but injecting equipment can generally be picked up at participating pharmacies, community health services and drug treatment agencies.

Non-A, non-B hepatitis – The term used to refer to a collection of symptoms that were eventually discovered to be mostly due to a virus eventually named hepatitis C in 1989; see ‘Hepatitis C’.

O

Opioid pharmacotherapy treatment (OPT) – A medication-based treatment for opioid dependence where the preferred opioid is replaced with a legally prescribed and dispensed opioid. It can prevent opioid withdrawal and help people cut down or stop taking other opioids. The three main opioid pharmacotherapy medications currently used in Australia are methadone (Biodone®) syrup, buprenorphine (Subutex®) sublingual tablets and combination buprenorphine and naloxone (Suboxone®) sublingual film; see ‘Methadone’. Pharmacotherapy for people diagnosed with opioid dependence goes by several different names: Opioid Pharmacotherapy Treatment (OPT – used on this website), Opioid Replacement Therapy/Treatment (ORT), Opioid Pharmacotherapy Program (OPP) or Opioid Substitution Therapy/Treatment (OST). The term ‘medication-assisted treatment of opioid dependence’ (MATOD) refers to treatments for opioid dependence that combine medication (pharmacotherapy) with access to counselling and health and social services.

P

PCR test – A blood test that looks for the hepatitis C virus in the bloodstream. The PCR (polymerase chain reaction) test looks for genetic material (or RNA — ribonucleic acid) specific to the virus. It is performed in two different ways. The first is a ‘qualitative test’ which determines whether hepatitis C is present or absent; the result can be positive (detected) or negative (not detected). The second is a ‘quantitative test’ which measures how much of the virus is present in the bloodstream. A PCR test can also be used to determine the genotype (strain or type) of hepatitis C present.

Pharmaceutical Benefits Advisory Committee – The Pharmaceutical Benefits Advisory Committee is an independent expert body providing advice to the Australian Government about which drugs and medicinal products should be listed on the Pharmaceutical Benefits Scheme and subsidised by the government.

Portal hypertension – A condition in which the pressure of blood in the portal vein (a major vein going to the liver) increases. The most common cause of portal hypertensions is cirrhosis of the liver. Portal hypertension can cause bleeding in the gastrointestinal tract (a part of the digestive system). 

R

Ribavirin – An antiviral medication previously used widely to treat hepatitis C. Ribavirin does not work when used alone and was used in combination with an interferon. While ribavirin is generally not used with the new direct-acting antiviral treatment, it can be recommended in rare cases where the first round of treatment is unsuccessful.

S

Side effects – An unwanted effect of a medical treatment. All medicines can cause side effects and these range from minor issues to significant problems that may require further medical treatment. Unlike previous interferon-based hepatitis C treatment, the new direct-acting antiviral treatment causes few side effects and any that do arise are usually minor. 

Spontaneous hepatitis C clearance – When the body clears the hepatitis C virus without treatment. Unlike a hepatitis C ‘cure’, which generally refers to curing the virus with treatment, spontaneous clearance occurs without any intervention. Spontaneous clearance usually occurs fairly soon (within six to 12 months) after acquiring the virus. Approximately 25% of people infected with hepatitis C spontaneously clear the virus.

Suboxone® (buprenorphine and naloxone) – A prescription opioid medication consisting of buprenorphine and naloxone that can be prescribed for pain and as an opioid pharmacotherapy treatment; see ‘Opioid pharmacotherapy treatment’. Combination buprenorphine/naloxone (Suboxone®) is a sublingual film designed to be absorbed under the tongue, but can produce withdrawal effects if injected. The addition of naloxone to buprenorphine was intended to discourage the injecting of opioid pharmacotherapy medication. Suboxone® is legal in Australia if prescribed or administered by a doctor. It is illegal to take it without a prescription, or to give or sell it to other people.