Government subsidy of direct-acting antivirals for hepatitis C is driving down the rate of liver transplants and deaths from the disease, a registry study suggests.

The previous steady climb in adult transplantation – at a mean rate of 3.5 a year – has been stymied, with 7.9 fewer transplants per annum since PBS listing of the drugs in 2016, researchers say.

They examined data on some 5300 transplants recorded in the Australia and New Zealand Liver and Intestinal Transplant Registry ) between 1990 and 2019 and compared data before and after universal access to direct-acting antivirals (DAAs) in the first study of its kind.

While 9% of liver transplants were performed for hepatitis C (HCV) in 1990 this had expanded to a third of all transplants by 2016, the study authors reported in Liver Transplantation.