Blogs2 August 2018

(A report back on Janice Pritchard-Jones's presentation - Nurses role when the Hepatitis C is cured but the Cirrhosis remains)

This topic was discussed by Janice Prichard-Jones in the 11th Viral Hepatitis Australasian Conference held in Adelaide.  

Hepatitis C is a major public health concern that needs to be made known to the community and those suffering need to know that it is a curable disease. It is the duty of the local health organisation whether it be a medical centre or a hospital to actively screen patients and do case findings for hepatitis C as a vast majority of infected people are unaware they have it. 

My name is David Young, I am a GP in rural NSW and having completed an Hep B s100 prescribers course last year I was invited to attend the 2018 Australasian Viral Hepatitis Conference in Adelaide. 

This blog is about the presentation by Dr Jane Davies on the topic of Hep B in Corrections: the Top End of the NT.

The theme of the conference was “No one left behind “and on Wednesday there were several presentations about how to identify and reach, high prevalence and under tested groups. Jeyamani Ramachandran talked about the under testing of psychiatric in-patients even though they are a high-risk group. Often, they have co-existing drug and alcohol issues which place them at risk from unsafe injecting and unsafe sex particularly when they are most unwell. They are often isolated, aboriginal and have prison experience.  Although they are mentally unwell in hospital it is a time to test and initiate discussion about the need for treatment for blood borne viruses. In the sample tested 57% were hepatitis C RNA positive. 

(A report back from morning sessions on Australasian Viral Hepatitis Conference Day 2)

What an inspiring conference the 11th viral Hepatitis Australasian Conference has been. A quick recap of the highlights of Day 2 of the conference. 

And so to the third day and the final session in the community and social research theme on specialised work with identified communities. 

(A report back on the Australasian Viral Hepatitis Conference Day 2)

Globally there is a move to developing point of care testing (POCT), with the aim to test and treat on the same day. New developments include an instant Hep B e-ag and ALT semi quantitive disposable diagnostic device, the combination of these positive results having an 80% correlation with more thorough investigations with hep B Viral Load, fibroscan and full bloods. Local TGA restrictions prevent the use of POCT currently.

(A report back from presentation of Dr Paula Binks)

I had the privilege of attending this session at the 11th Australasian Viral Hepatitis Conference. Paula presented not only herself but introduced her community collaborators who were instrumental in the delivery of this project. This project was in response to a community identified need for education for HBV patients in their outreach liver clinic and in response to this Paul and her team initially developed a Hepatitis B story app in both English and Yolngu Matha the local Indigenous language. 

(A report on the end of day discussion panel featuring Dr Sam Elliott, Dr Annie Balcomb, Dr Joss O’Loan, Dr Belinda Greenwood-Smith, Dr Heather McNamee, and Dr Zak Baig)

Takeaway lessons from the end of day discussion panel: 

• It is a minimum requirement for GPs to screen for hepatitis C correctly, diagnose and then refer or treat if required. We cannot have GPs carrying the workload on their own; it is up to GPs whether they want to upskill and treat patients with hepatitis C. However they cannot choose not to screen and diagnose. Screening and diagnosis of Hep C will be the main work of GPs in the future. 

(A report back on Dr Jacqui Richmond's presentation at Viral Hepatitis Nurse-led Models of Care Forum)

Great contrasting placement of Jacqui’s presentation after Leith Morris discussed the reasons why people don’t seek treatment. Jacqui’s research into how it feels to be cured revealed 3 main themes: the psychological impact (a profound sense of well-being more than physical health); feeling normal; and the relief of not being able to transmit the virus.  
You can read more about the results here https://rdcu.be/32oG. If you are looking at how to design messaging for a hep C treatment campaign all of the presentations in this stream “responding to challenges in hepatitis C care and treatment” are well worth looking at. 

(A report back on Dr Edmund Tse's presentation - HealthELink, Online Model of HCV Treatment Within South Australian Prisons - Australasian Viral Hepatitis Conference Day 2)

Absolutely brilliant Dr Tse, what an amazing vehicle you have developed especially designed for the less frequent and less confident prescribers of hepatitis C medicines!   This online platform was designed specifically for use by SA prison doctors and can be embedded into GP medical records software.