hcn105

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• May 2025

Pathogens Don’t Care About Your Politics

Plus Measles, Hep D and more

Correspondence: Please send all correspondence to The Editor at PO Box 782, Kent Town, SA 5071, or email editor@hepatitissa.asn.au

Editor: James Morrison

Regular Contributors: Cecilia Lim, Rose Magdalene

Some photos in this publication may have been altered to disguise identifying details of members of the public.

Disclaimer: Views expressed in this newsletter are not necessarily those of Hepatitis SA. Information contained in this newsletter is not intended to take the place of medical advice given by your doctor or specialist.

We welcome contributions from Hepatitis SA members and the general public. SA Health has contributed funds towards this program.

This resource was prepared and printed on Kaurna Country.

ISSN 2651-9011 (Online)

About the Cover: Derived from an image by Freepik

input from people from different countries, and that collaboration is really core to our safety across the world,” she said.

Such collaboration, she added, helps to identify outbreaks, and have an immediate response so that these outbreaks don’t go out of control.

“We feel like it’s not happening in our country, it won’t affect us but we saw what’s happening with ebola. People travel to these places and bring them back.

“There are no boundaries. You may have a boundary on a map, but it doesn’t happen in real life. So this is very concerning to us, this break in the global health ecosystem.”

Dr Wang raised the issue of the sudden withholding of regular CDC reports such as the Flu Surveillance Report and the Morbidity and Mortality Weekly Report (MMWR).

“The MMWR which had been around since the 1800’s and put out weekly since the 1950’s, for the first time did not have a publication,” she said. “It is concerning because that publication is used to convey what is happening in a timely way, such as what is happening with Avian Influenza…

“Without these reports, we are operating in the dark.

“Besides that, there are other databases suddenly not available. Fortunately we heard that some scientists had archived some of these pages, so we still have access to them for reference.

“As a scientific medical community we have to keep on top of these things because during the middle of this transition, we still need access to … reliable information.”

Dr Wang also spoke of the need for the medical community to rise to the occasion to fill in the sudden gap in services for vulnerable, at-risk communities. This reflects the joint letter that said, “The sudden sabotage of disease control efforts has profound and immediate effects, especially among marginalised and under-served groups who already experience health and social inequities.

“We know that—along with infectious diseases—reproductive health, migrant health, global health, and activities focused on advancing equity are among the most vulnerable targets. But in fact, no one is safe; in our interconnected world, status does not insulate individuals or countries from public health threats.”

“If there is a shift in prioritisation and funding,” they said, “there are ways of transitioning with transparent dialogue, rather than this abrupt and wholesale closure of lifesaving programs that leads to the abandonment of many stakeholders and recipients.

“The current catastrophic threat to global health infrastructure must be stopped.”

READ MORE:

The Letter: bit.ly/lancethepletter

Dr Wang’s Interview: bit.ly/wanginterview

Dr Susan Wang

Measles & Your Liver: Get Vaccinated!

Measles is a highly infectious virus that evolved to be able to infect humans at least 1000 years ago. As well as its best-known symptoms, such as fever and a rash that develops into blister-like bumps, it can also affect other parts of the body, like the liver.

Measles was once eliminated in Australia. Given the current alarming measles outbreak in the US, and recent individual cases appearing in South Australia, this is sadly likely to change. While this is of concern to everyone, it has extra relevance for those with damaged or compromised livers, as may be the case with people living with viral hepatitis.

Research on measles often finds that in the vast majority of cases, when someone is infected with measles there is a significant, though usually temporary effect on their liver. This can often lead to jaundice (hyperbilirubinemia), a noticeable yellowing of the skin and eye-whites due to excess bilirubin in the body.

Bilirubin is a red/yellow chemical caused by the normal breakdown of red blood cells, and is usually excreted from the body through the action of a healthy liver. When the liver isn’t working properly, bilirubin levels can rise and the chemical spreads

throughout the body, with visible and sometimes dramatic results.

The association between measles and liver damage is higher among young adults than in children, but can happen at any age. This disruption to liver function usually resolves itself as the measles infection progresses, lasting up to perhaps two weeks, and there is unlikely to be any long-term damage. However, some research shows a clear correlation between the severity of hepatic response and the occurrence of secondary bacterial infections. Because of this liver dysfunction, having pre-existing hepatitis (like Hepatitis A, B, or C) could potentially complicate a measles infection, but the exact nature and extent of this interaction is not fully understood due to a lack of research. Basically, it’s probably better to be safe than sorry, and anyone living with hepatitis should protect themselves from measles.

Measles vaccination with one dose was introduced in the late 1960s and measles cases dropped dramatically. In 1994, a second measles dose was added to the national childhood immunisation schedule to increase the level of measles protection in the community. All children born in Australia are now routinely

vaccinated against measles at 12 and 18 months as part of the National Immunisation Program schedule.

People born between 1966 and 1994 are known to be at a greater risk of measles because they are less likely to have had a measles vaccine, or they have had only one dose instead of the currently recommended two. Because there was less measles disease in the community (due to the measles vaccine) these people are also less likely to have immunity from natural infection than people born before 1966.

If you’re in this age group and not sure if you have had two measles doses you should check with your GP. It’s safe to have another measles dose if you’re not sure, particularly if you’re planning to travel overseas. If you have not had any measles vaccinations then you should have two doses given at least four weeks apart.

Needless to say, if you don’t have hepatitis A or hepatitis B immunity, get vaccinated for those as well. If you’re unsure of your immunity status, speak to your GP about getting tested. For more information give the Hepatitis SA Helpline a call on 1800 HEP ABC (1800 437 222), or message or chat with us at hepsa.asn.au.

Need to Act on Hep D Now

The Australian Pharmaceutical Benefits Scheme (PBS) has recently rejected an application for a new drug, bulevirtide, to be available at subsidised rates for treatment of hepatitis D, despite submissions from community and health organisations.

Hepatitis D is the most severe form of viral hepatitis carrying with it a 70–80% risk of cirrhosis in five to ten years, and liver cancer within ten years. It is uncommon in Australia, and only infects people already living with hepatitis B, putting them at a significantly higher risk of serious disease and death. About a quarter of people who develop cirrhosis from hepatitis D will die of liver failure.

The hepatitis D virus can only live in people already infected with hepatitis B, because it doesn’t have its own cellular “machinery” for reproduction, and relies on making use of that provided by the cells of hepatitis B. It is the smallest known pathogenic virus in humans.

Hepatitis D is spread when infectious body fluids (blood, saliva, semen and vaginal fluid) come into contact with body tissues beneath the skin (for example, through needle punctures or broken skin) or mucous membranes (the thin moist lining of many parts of the body such as the mouth, throat and genitals). Hepatitis B vaccination will prevent both hepatitis B and hepatitis D.

In Australia, hepatitis B prevalence is highest among migrant communities from countries or regions of higher prevalence, as well as First Nations communities. It is estimated that there are around 12,000 South Australians living with hepatitis B. From 2020 to 2024 an average of 232 cases of hepatitis B and 7 cases of hepatitis B and D co-infection were notified per year in South Australia.

We were significantly behind in our efforts to reach the 2022 national hepatitis B targets for diagnosis and linkage to care, and also behind in reaching 2030 global elimination

From ‘Hepatitis D: Looking Back, Looking Forward, Seeing the Reward and the Promise’ by Theo
et al, in Clinical Gastroenterology and Hepatology

targets. It is likely that hepatitis D is also underdiagnosed.

The current treatment options for hepatitis B/hepatitis D chronic infection are limited, and need to be carefully discussed with a person’s treating doctor.

A new targeted treatment, bulevirtide, has been approved by the Therapeutic Goods Administration for use in Australia. It has a much higher efficacy and is more well tolerated than the current treatment options. Buleviritide works by blocking the hepatitis D virus’s access to regenerated liver cells, letting the immune system eliminate infected cells. This can result in prevention of viral replication, and subsequent reduction in inflammation and associated liver damage. However, Buleviritide is not currently approved for subsidised access through the PBS.

Considering the fact that those most affected by hepatitis B—and therefore vulnerable to hepatitis D—already face barriers to healthcare, removing the cost barrier to accessing this more effective treatment is

surely vital to managing this deadly form of hepatitis. Its rejection for listing on the PBS is no doubt disappointing to those in the sector who have lobbied for it.

The peak body for health professionals in the field, ASHM, recommends that people living with hepatitis B automatically receive a hepatitis D antibody test—REFLEX testing is a straightforward and simple way to do this—and anyone testing positive should then have a hepatitis D PCR test to confirm active infection and inform clinical care. For those who commence treatment, twice-yearly monitoring via hepatitis D PCR tests is then extremely important.

Unfortunately, the cost of the medication itself is just one of the barriers to clinical management faced by people living with hepatitis D. We also need to remove the costs associated with the hepatitis D PCR tests, which are an essential component of determining eligibility to commence treatment, and to monitor the clinical benefits, and consequently the duration, of treatment.

Hepatitis SA joins the call for action on hepatitis B and D. Improving access to testing and guide-line based care including subsidised, effective treatments is key to improving outcomes for people living with hepatitis B and D co-infection.

See our special issue on Hepatitis D at issuu.com/hepccsa/docs/hcn76

Want to Get Tested? We’ll Come to Your Community

A lot of “thankyous” and laughter… not what you’d normally see in a testing clinic but that was the experience at two liver health check clinics Hepatitis SA held recently. Both clinics were delivered at community venues familiar to participants. Even for those who had not visited the venues before, the settings were, nonetheless, culturally familiar to them.

Going to your GP to ask for tests and scans can be challenging for anyone. Add to that cultural and language barriers, uncertainty in navigating the health system, or transport difficulties in getting to multiple locations. Such barriers prevent people from getting the appropriate health checks they need for chronic conditions with little symptoms. Bringing testing and consultation into the community in culturally-friendly environments goes a long way towards breaking down these barriers.

With new Australian data showing an increase in deaths from liver cancer caused by hepatitis B, there is urgent need to ramp up testing and increase clinical monitoring of people living with hepatitis B. Short of universal testing—advocated by Hepatitis Australia—innovative strategies are needed to reach high-risk communities.

Building on the success of the first liver health clinic in partnership with the Chinese Welfare Services (CWS), Hepatitis SA delivered a second clinic in March, this time in the suburbs, with the Chinese Association of South Australia (CASA). While CWS was very much part of the community service eco-system, the second hosting organisation, CASA, was a fully volunteerdriven community group with no staff, paid or unpaid.

That the second clinic proved just as successful as the first demonstrates the viability of this model of delivering testing to harder-to-reach communities. Despite the lack of paid workers to support or liaise with the clinic providers, community leaders are able to step up to fill the gap in facilitating the clinics. South Australian MLC, the Hon. Jing Lee, who visited the second clinic for an overview of the process, even sat down for a discussion with project workers, on which communities might be interested in, and benefit from, similar liver health check events. The overwhelming response from both testing clinics was one of gratitude: for the ease and convenience, the quality of the service and the fact that it was free of charge.

There were also many who expressed relief, welcoming the “peace of mind” the tests, scan and consultation gave them – especially those living with viral hepatitis or have/had close family members with hepatitis.

One participant in particular, worried about the impact of hepatitis B on their health, was extremely thankful for the fibroscan and consultation with viral hepatitis nurse, Jeff.

“I had been feeling so anxious, especially after my mother passed away from liver

CASA President Tan Tar Kim getting tested by project investigator Jen, as SA MLC
Jing Lee looks on

The hep B and C tests are done using a small drop of blood, with results in minutes

failure. I live with hepatitis B and keep asking myself what else can I do?  I try to eat healthy, exercise regularly, go for check-ups, but is that enough? What else can I do?

“The fibroscan results were such a relief, and the consultation with the nurse was so useful and reassuring. He explained how the disease progresses and what I can do to keep an eye on it, and what options are available.

“I now feel so much more relaxed about it.”

The testing clinics are a small sub-study of the National HCV Point-of Care Testing program facilitated by the Kirby Institute in which Hepatitis SA participates, and offers hepatitis point-of-care tests and liver fibroscans to South Australian multi-cultural communities, with a focus on groups deemed to be at higher risk of hepatitis B and/or hepatitis C.

Participants are tested for hepatitis B and screened for hepatitis C antibodies. The hepatitis B diagnostic test looks for the hepatitis B surface antigen which is a marker of current infection. The hepatitis C test used in this pilot study is a newly approved test that looks for hepatitis C antibodies which are indicative of prior or current hepatitis C infection. Both tests are carried out with tiny drops of blood extracted via a finger prick. Results for the hepatitis B test is available in 15 minutes, and the hepatitis C antibody test in 60 seconds.

Anyone testing positive for hepatitis C antibodies, indicating they had previously been exposed to the hepatitis C virus, will be given a hepatitis C diagnostic test with a GeneXpert machine, which returns results in an hour.

Participants then have a consultation with a SA Health specialist viral hepatitis nurse who will also give them a fibroscan. The hepatitis B and C tests were provided by the Kirby Institute, funded by the Australian government, to “enhance assessment of liver disease and viral hepatitis among migrants and culturally and linguistically diverse people”.

Hepatitis SA has so far tested 43 people in two clinics and there are plans for more community-based testing.

Community testing clinic in progress at the Chinese Welfare Services premises in the city

Call for Universal Hep B Testing to Stop Rise in Liver Cancer Deaths

Hepatitis SA is enthusiastically backing Hepatitis Australia’s call for universal hepatitis B (HBV) testing, after new data confirmed the silent role of chronic hepatitis B in Australia’s rising liver cancer deaths, a call also backed by Cancer Council Victoria.

New data shows that liver cancer deaths caused by chronic hepatitis B are increasing in Australia. The data from the WHO Collaborating Centre at the Doherty Institute revealed that in 2023, 460 Australians died due to complications from chronic hepatitis B, which is a 10.6% increase in deaths nationally since 2017, following years of gradual decline. Of these deaths, a massive 82% were attributable to hepatocellular carcinoma (the most common form of liver cancer) caused by a chronic hepatitis B infection.

As the Australian election campaign rolled on, Hepatitis Australia was asking for the nationwide rollout of a universal offer of hepatitis B testing for people aged over 25, to combat this increasing cancer wave. This means offering free and easy HBV tests to people as a routine part of their health care, just as GPs now regularly suggest blood tests to monitor other health issues such as cholesterol, indications of diabetes, and organ dysfunction.

More than 220,000 people in Australia live with hepatitis B, and at least a quarter of them (55,000+ people) do not know they have it. Without medical intervention, one in four people living with chronic hepatitis B will die from liver cirrhosis or liver cancer. Much broader hep B testing could help avoid tens of thousands of preventable deaths.

The Royal Melbourne Hospital’s Professor Benjamin Cowie, Director of the WHO Collaborating Centre for Viral Hepatitis at the Doherty Institute, said these deaths could be prevented through increased testing and linking those affected to care.

“In recent years, we have seen an increase in deaths related to chronic hepatitis B. This is partly due to an ageing population, but also to not enough people receiving the adequate care and treatment they need to manage the virus,” Professor Cowie said.

“We will not eliminate hepatitis B or reduce liver cancer deaths without universal testing for people over 25,” Hepatitis Australia CEO Lucy Clynes said. “Hepatitis B is often symptomless until it’s too late. Diagnosis unlocks access to simple, effective treatment that protects the liver and prevents cancer. But people can’t get care if they don’t know they’re living with this virus.”

The call for expanded testing is grounded in the federal government’s own draft Fourth National Hepatitis B Strategy, which outlines how Australia can meet its ambitious goal to eliminate hepatitis B as a public health threat by 2030. The final Strategy is due to be released soon. To achieve this goal, 90% of people living with hepatitis B must be diagnosed, and 80% engaged in care.

At the moment, only 73% are diagnosed, and an alarming less than 25% are in regular care. Hepatitis Australia is urging the Commonwealth to fund and implement a universal testing offer in primary care for people aged 25 and over, the group most at risk of undiagnosed, chronic infection. And mean-

while, liver cancer rates in Australia climb each year.

“Most people with hepatitis B got it at birth or in early childhood and have no idea they carry the virus. These people aren’t being reached through current risk-based approaches,” Ms Clynes said. “We commend the federal government for its national, strategic approach and for the ongoing investment in viral hepatitis. A universal offer of testing is the critical next step in hepatitis B elimination.”

The Strategy acknowledges that testing based on risk factors alone has failed to lift diagnosis rates meaningfully in the past decade, which means that if current trends continue, Australia will fall woefully short of its 2030 targets. The Strategy explicitly supports offering population-wide testing as a path forward, so it is hoped that whoever forms government in May 2025 will have the courage and determination to follow through.

READ MORE: doherty.edu.au/viralhepatitis

Age-standardised incidence rates for liver cancer, 1982 to 2019, by sex

Closing the EverWidening Gap

Despite the rejection of the Voice in the 2023 referendum, some working in the Aboriginal and Torres Strait Islander sector still see hope. Speaking on the recently released Closing the Gap 2024 Annual Report, Aboriginal and Torres Strait Islander Social Justice Commissioner, Kate Kiss, notes, “Coming off the back of the 2023 Referendum, our communities are still reeling from the result. However, if 2024 has demonstrated anything, it is Aboriginal and Torres Strait Islander peoples’ resilience and commitment to pushing for equity and healing for our peoples, continuing to make strides despite the setbacks and barriers we continue to face.”

The Close the Gap campaign was officially launched in 2007 to address the unacceptable gap in life expectancy and other health indicators between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians; and helped influence the establishment of the Joint Council on Closing the Gap, and the formation of the National Agreement on Closing the Gap, which was developed in partnership between Australian governments and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations (the Coalition of Peaks) in 2020.

In its 16th annual report to mark Close the Gap Day (20 March, 2025) the Close the Gap Campaign has focused on shared decision-making, strengthening and building the community controlled sector, transforming government organisations, and shared access to data.

The report’s themes of agency, leadership, and reform underscore the pivotal role Aboriginal and Torres Strait Islander leaders and communities continue to play in embedding the four Priority Reform Areas outlined within. The report emphasises both the on-

going challenges and the tangible solutions needed to close the health and wellbeing gap for Aboriginal and Torres Strait Islander peoples. The report showcases how the closing the gap priority reform areas are being implemented to create lasting change.

Priority Reforms

A central focus of this year’s report is the success of First Nations leaders who are actively shaping solutions and paving the way to close the gap. These leaders and their organisations have shown steadfast commitment to advancing the rights and aspirations of Aboriginal and Torres Strait Islander communities-ensuring the survival, dignity and wellbeing of Indigenous Australians.

The four priority reform areas are at the heart of the 2025 report.

• It is Aboriginal and Torres Strait Islander agency and leadership, that is best placed to advise, build and embed critical reform across sectors to improve the health and wellbeing of our peoples and communities.

• To significantly advance progress across the socio-economic targets in the National Agreement, governments must adopt rights-based policy approaches, provide long-term funding, and engage in shared decision-making with Indigenous communities.

• Governments must establish genuine, collaborative partnerships with Aboriginal and Torres Strait Islander peoples at all levels of decision-making; including co-designing policies, programs, and services that reflect the needs, aspirations, and rights of Indigenous communities.

• Embedding the Priority Reform areas is crucial to reforming the structures, poli-

cies, and practices that marginalise and disenfranchise Indigenous peoples.

Looking Ahead

“We are proud to share this report, which not only highlights the achievements made in the pursuit of equity and justice but also reinforces the importance of continuing to elevate Indigenous voices,” said Karl Briscoe, Co-Chair of Close the Gap. “This campaign, our work, is about amplifying and championing Aboriginal and Torres Strait Islander-led solutions and showing how our leadership is the key to achieving genuine, sustainable reform.”

Briscoe’s sentiments were echoed by his cochair, Commissioner Kiss, who also stressed the significance of holding governments accountable for their commitments.

“Our recommendations in this report are clear,” Kiss said. “We urge all levels of government to fulfill their obligations under the National Agreement on Closing the Gap. This landmark policy initiative is the most comprehensive to date, aimed at delivering improved outcomes across critical health and wellbeing indicators for First Nations peoples. All state and territory governments

have signed onto the National Agreement, and they must be held accountable for its implementation.”

The Close the Gap Campaign report underscores the importance of building an enabling environment at the departmental and agency level, where the targets set by the National Agreement can be effectively achieved at the local level. According to Commissioner Kiss, without the proper framework, progress will remain stagnated.

“Through their collective efforts, Aboriginal and Torres Strait Islander peoples have made meaningful strides. However, there is still much more to be done to ensure that the health and wellbeing of First Nations peoples are truly prioritised,” she added.

As the Close the Gap Campaign continues its mission, the report serves as both a celebration of the progress made and a call to action for the ongoing work required to achieve true equality and justice. It offers a roadmap for implementing and supporting community agency.

READ MORE: closethegap.org.au/ctg-annual-reports

Photo: Ann Smith/iStock

Understanding the tests needed to diagnose viral hepatitis infection can be complex. This collection of resources in our library is suitable for community members and can assist with explaining tests and interpreting their results.

A note about Hep C testing

Until recently, the presence of hepatitis C virus in the blood was detected with a Polymerase Chain Reaction (PCR) test on blood samples. Now hepatitis C rapid tests are available at selected locations in Adelaide. These diagnostic tests require only a drop of blood collected via a fingerstick, giving results within an hour.

To find out the time and location of rapid testing clinics, call Hepatitis SA on 1800 437 222 or check out the calendar at bit.ly/ heptestcalendar.

In Our Library Viral Hepatitis Tests

Hepatitis A tests explained Pathology Tests Explained Ltd (PTEx), Sydney, 2023. Webpage. Explains what is being tested, when tests might be requested and what the results mean. Includes common questions about transmission, periods of contagion, and prevention/ vaccination.

bit.ly/pathhepa

Hepatitis B testing

Hepatitis SA, Adelaide, 2024. Webpage.

Provides an explanation of hepatitis B tests and a guide to interpreting the results. Includes links to information sheets in Chinese, English and Vietnamese. bit.ly/hepsahbvtest

The Test

Hepatitis SA, Adelaide, 2018. 6p. graphic booklet/comic.

An engaging comic about hepatitis B testing. Translations by members of relevant communities in Adelaide, with the generous permission of the Hepatitis B team at the Charles B Wang Community Health Centre. Read online only: may need to turn off ad blockers to view complete ISSUU resources. Printed copies of this resource are available from Hepatitis SA: email admin@hepsa.asn.au. Also available in Chinese, Indonesian and Vietnamese. bit.ly/comictest

Hepatitis SA provides free information and education on viral hepatitis, and support to people living with viral hepatitis.

Postal Address:

Kaurna Country PO Box 782

Kent Town 5071

(08) 8362 8443 1800 437 222

www.hepsa.asn.au

Community News: hepsa.asn.au/ communitynews

Library: hepsa.asn.au/library

@HepatitisSA

@hep_sa

Resources: issuu.com/hepccsa

Email: admin@hepatitissa.asn.au

Free hepatitis A, B and C information, confidential and non-judgemental support, referrals and printed resources.

We can help. Talk to us. Call or web chat 9am–5pm, Mon–Fri

Information Support

HEPATITIS SA BOARD

Chair

Arieta Papadelos

Vice Chair

Bill Gaston

Secretary

Sharon Eves

Treasurer

Michael Larkin

Ordinary Members

Lindy Brinkworth

Bernie McGinnes

Janice Scott

Memoona Rafique

Lucy Ralton

Tamara Shipley

Kerry Paterson (CEO)

Hepatitis SA has a wide range of hepatitis B and hepatitis C publications which are distributed free of charge to anyone in South Australia.

To browse our collection and place your orders, go to hepsa.asn.au/orders or scan the QR code below:

Viral Hepatitis Community Nurses

Viral Hepatitis Nurses are nurse consultants who work with patients in the community, general practice or hospital setting. They provide a link between public hospital specialist services and general practice, and give specialised support to general practitioners (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 experienced in prescribing medications for hepatitis C or accredited to prescribe section 100 medications for hepatitis B. They can be contacted directly by patients or their GPs:

CENTRAL ADELAIDE LOCAL HEALTH NETWORK

Queen Elizabeth Hospital

Phone: 0423 782 415, 0466 851 759 or 0401 717 953

Royal Adelaide Hospital

Phone: 0401 125 361 or (08) 7074 2194

Specialist Treatment Clinics

NORTHERN ADELAIDE LOCAL HEALTH NETWORK

Phone: 0401 717 971 or 0413 285 476

SOUTHERN ADELAIDE LOCAL HEALTH NETWORK

Phone: 0466 777 876 or 0466 777 873

Office: (08) 8204 6324

Subsidised treatment for hepatitis B and C are provided by specialists at the major hospitals. You will need a referral from your GP. However, you can call the hospitals and speak to the nurses to get information about treatment and what you need for your referral.

• Flinders Medical Centre Gastroenterology & Hepatology Unit: call 8204 6324

• Queen Elizabeth Hospital: call 8222 6000 and ask to speak a viral hepatitis nurse

• Royal Adelaide Hospital Viral Hepatitis Unit: call Anton on 0401 125 361

• Lyell McEwin Hospital: call Bin on 0401 717 971

Visit hepsa.asn.au - no need to log in, lots of info & pdates

Follo the HepSAY blog - hepsa.asn.a /blog

Order print resources - hepsa.asn.a /orders/ Follo s on T i er @hep_sa or Facebook @Hepa sSA

Full range of syringes and needles. Water and filters also available in limited quantities for free.

Free hepatitis A, B and C information, confidential and non-judgemental support, referrals and printed resources. We can help. Talk to us. Call or web chat 9am–5pm, Mon–Fri

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