Viral Hepatitis Nursing Support
Treatment is available for people with viral hepatitis and can prevent the progression to severe liver disease including liver cancer.
Advice for GPs
A team of Viral Hepatitis Support Nurses in SA provide advice to GPs on the management of patients with viral hepatitis, including assistance with referral to specialists. Patients may also speak to the nurses directly. Support is also available for people in country areas.
You can speak to the nurse in your local area:
- Royal Adelaide Hospital — Central Adelaide Local Health Network
Phone: 0401 125 361 or (08) 7074 2194 (Anton)
Fax: (08) 8222 5883
- The Queen Elizabeth Hospital — Central Adelaide Local Health Network
Phone: 0423 782 415 (Margery) or 0401 717 953 (Jeff)
Fax: (08) 8240 9609
- Northern Adelaide Local Health Network
Phone: 0401 717 971 (Lucy) or 0413 285 476 (Michelle)
Fax: (08) 7485 4011
- Southern Adelaide Local Health Network
Phone: 0466 777 876 (Rosalie) or 0466 777 873 (Emma)
Office: (08) 8204 6324
Fax: (08) 8204 6420
Tests and follow-ups
It is important for GPs to follow up the hepatitis C antibody test with a hepatitis C PCR (Polymerase Chain Reaction) test as approximately 25% of people clear the virus naturally. Patients who have a positive hepatitis C PCR test have active infection and should receive further assessment.
Contacts of patients who have a positive hepatitis C PCR test should be traced according to risk history, particularly needle sharing partners/networks.
It is important for GPs to complete all three serology tests required to diagnose chronic hepatitis B (HBsAg, anti-HBc & anti-HBs). If the patient is suspected to be acute an additional test can be ordered (IgM anti-HBc). It is now known that people who were previously considered to have 'unresolved hepatitis B virus carrier state' do in fact have chronic hepatitis B infection, which requires lifelong recall and monitoring for disease progression, even when asymptomatic.
Contacts of patients with chronic hepatitis B should be traced according to risk and family history, particularly mother to baby transmission.
GPs are also encouraged to investigate each patient’s current hepatitis A and B vaccination status. People with hepatitis C infection are at risk of severe liver disease if co-infected with either hepatitis A or B. People with hepatitis C, household contacts or sexual contacts of people with hepatitis B, and certain population groups are eligible for free hepatitis B vaccination and GPs can contact the SA Health Immunisation Section to check eligibility on 1300 232 272.
Nursing Model of Care for Viral Hepatitis Management in South Australia
The Viral Hepatitis Model of Care Reference Group (the Reference Group) oversees initiatives to increase access to viral hepatitis care in South Australia. This Reference Group was originally established to develop a comprehensive Nursing Model of Care for Hepatitis C Treatment in South Australia. The hepatitis C Clinical Practice Consultant nurses have led the development of the Nursing Model of Care for Hepatitis C Treatment in South Australia which was endorsed by the Reference Group in December 2010.
The Nursing Model for Hepatitis C Treatment in South Australia was revised in January 2016 to incorporate the management of people with hepatitis B and D and renamed Nursing Model of Care for Viral Hepatitis Management in SA, and again in November 2017 to reflect updated guidelines for the management of viral hepatitis. This revised model of care provides the overarching framework to guide the implementation of the Viral Hepatitis Nursing Program.
Additional information about diagnosis and management of viral hepatitis in general practice, and relevant training courses, can be found on the ASHM website. A copy of the National hepatitis B and hepatitis C testing policies can be accessed via the ASHM Testing Portal.
Role of the viral hepatitis nurse
Viral Hepatitis Nurses work with patients in the community, GP or hospital setting.
They provide a link between public hospital specialist services and general practice, and give specialised support to GPs to assist in the management of patients with hepatitis B or hepatitis C.
With advanced knowledge and skills in testing, management and treatment of viral hepatitis, they assist with the management of patients on antiviral medications, and work in shared care arrangements with GPs who are accredited to prescribe s100 medications.
For more information go to the viral hepatitis nursing support page or view the role of the viral hepatitis nurse video on YouTube below.
Managing chronic hepatitis B
We now know there is no such thing as a healthy carrier of hepatitis B. Current estimates suggest 1 in 5 people will die from liver cancer or liver failure if hepatitis B is left untreated. All patients with chronic hepatitis B (CHB) infection need lifelong management and routine follow up by their GP. A vaccine is available to prevent CHB and associated liver cancer.