Post-crisis imaginaries in the time of direct-acting antiviral hepatitis C treatment. (February 2023)

• Record Type: Journal Article
• Authors: Fomiatti, Renae; Farrugia, Adrian; Fraser, Suzanne; Moore, David; Edwards, Michael; Treloar, Carla
• Is Part Of: Time & society. Volume 32:Number 1(2023)
• Page Start: 50
• Page End: 74
• Publication Date: 2023-02
• Subjects: Temporality -- hepatitis C -- post-crisis -- cure -- hepatitis C treatment; Time -- Social aspects -- Periodicals; Time -- Sociological aspects -- Periodicals; 304.23
• DOI: 10.1177/0961463X221128736
• Languages: English
• ISSNs: 0961-463X

Abstract

Until the recent introduction of direct-acting antiviral (DAA) medications, the only available hepatitis C treatments were lengthy and onerous interferon-based therapies, with relatively weak success rates. While experiences of interferon-based treatment have been well documented, there is a need to better understand how the experiences of the 'old' treatments shape contemporary treatment experiences. This article uses the concept of 'post-crisis' developed in critical scholarship on HIV/AIDS, and recent theorisations of 'curative time', to explore the relationship between contemporary treatment experiences and the legacies of interferon-based therapies. In mobilising these concepts, we trouble linear temporal logics that take for granted distinctions between the past and present, old and new, and cure and post-cure, and draw attention to the fluidity of time and the overlapping co-constitutive terrains of meaning that shape treatment experiences. Drawing on 50 interviews with people affected by hepatitis C, we argue that the curative imaginary of DAA treatments – that is, the temporal framing applied to hepatitis C in which cure is expected and assumed – is shaped by the logic of crisis. Here, knowledge of and the possibilities for the new treatments and living with hepatitis C remain tethered to crisis accounts of interferon. Unlike HIV/AIDS, in which the disease itself was figured as crisis, many participants described interferon-based treatments as the crisis: as worse than living with hepatitis C. While the new treatments were widely described as simple and easy, we argue that treatment is not so straightforward and that the crisis/post-crisis relation is central to this complexity . We conclude by considering the significance of these post-crisis enactments for understanding the recent plateauing of DAA treatment uptake, and reflect on how post-crisis futures of hepatitis C 'cure' need to address the ongoing constitutive effects of interferon-based treatments.