#82 HepSA Community News

Community News

#82 • June 2019

Hepatitis C: The Cure is pure gold!

FREE!

Please take one

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

Online: www.hepsa.asn.au HepSAY Blog: hepsa.asn.au/blog Library: hepsa.asn.au/library @HepatitisSA

@hep_sa Resources: issuu.com/hepccsa Email: admin@hepatitissa.asn.au Cover: Liver Health Days: see p8 for details

Street Address: 3 Hackney Road, Hackney Postal Address:

PO Box 782 Kent Town SA 5071

Phone:

Fax:

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

(08) 8362 8443 1800 437 222 (08) 8362 8559

Contents

1 LiveR Life HEPATITIS SA BOARD

4 Immunosuppression

Chair Arieta Papadelos

6 Resources

Vice Chair Bill Gaston Secretary Deb Perks Treasurer Michael Larkin Ordinary Members Julio Alejo Catherine Ferguson Sharon Jennings Maggie McCabe Sam Raven Kerry Paterson (EO)

ISSN 2651-9011 (Online)

8 Liver Health Days 9 Viral Hepatitis Nurses 10 The Latest Data 13 What’s On? 14 In Our Library

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.

THE

P U W O L L O F

I

n 2017, we reported on the beginning of Hepatitis SA’s association with the LiveRLife Project (see issue 72). The Outreach Hepatitis C Peer Education & Support Project and Clean Needle Program Peer Educators from Hepatitis SA were assisting researchers from The Kirby Institute, at the University of NSW, with this research.

LiveRLife is a Viral Hepatitis Clinical Research Program, supported by Merck Sharpe & Dohme, Australia. The project, which commenced in 2012, is designed for drug and alcohol settings, especially for people with a history of injecting drug use, and aims to assess subjects’ knowledge of liver disease, their willingness to receive assessment for liver disease, and any barriers there might be to their receiving it.

Liver nurses, DASSA staff and Hepatitisa SA peer educators at DASSA.

The Kirby Institute collaborated with Drug and Alcohol Services South Australia (DASSA), who hosted the LiveRLife Liver Health Campaign here in SA, and provided the

clinical nurse assessments for liver disease screening of participants, as well as assessments of liver fibrosis.

Hepatitis SA peer educators

»

(continued on p2)

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

1

»

(continued from p1)

supported the participants to complete a self-administered survey to collect de-identified demographic information, injecting history, liver disease and HCV history, and

knowledge of liver disease, HCV and treatment.

Following completion of the survey, a non-invasive liver scan (FibroScan) was performed and the clinic nurse

DASSA North 12-13 March 2019 PARTICIPANT DETAILS

42

36%

Recruited

Male

42

Mean age

17%

57%

Aboriginal ethnicity

Currently receiving OST

42%

methadone

33%

Unstable housing

62%

Ever been in prison

58%

buprenorphine

55%

Excessive alcohol use

DRUG USE

HCV

74%

Ever tested

90%

Injected drugs in last six months

79%

Injected drugs in last month

43%

Tested in the last year

Most commonly injected drug in last month, among all recruited 29% Heroin 45% Amphetamines 3% Other opioids 3% Other

*Ever RNA positive = RNA +ve at POC; RNA –ve at POC & ever treated for HCV; missing POC & self-reported ever RNA +ve ^HCV prevalence presented for only those with valid POC result NOTE: these data are provisional and may change when additional blood tests are analysed

2

HEPATITIS SA COMMUNITY NEWS 81 • April 2019

57%

Ever HCV RNA +ve*

75%

assessed the participant’s medical history and known or likely liver disease related conditions. If required, referrals for hepatitis C treatment were then made.

A dried blood spot sample was then collected for future hepatitis research analysis.

Clients were then encouraged to come back to see the nurse 2-12 weeks later for follow-up.

Australia-wide, 839 people were recruited to this study during liver health campaign days between 2014 and 2018, from 17 different drug and alcohol clinics. Most of the participants (66%) were male, most (64%) had injected drugs in the month before they took part in the study, and most of the participants (67%) were receiving opioid substitution therapy at the time.

Key Findings •

Almost half of the participants (45%) were found to have active hep C infection. Some of these people (15% of those living with with HCV) were unaware that they had hep C.

•

Overall, about one third (29%) of participants who had hep C went on to receive treatment within one year of taking part in the study.

Initiated HCV therapy

HCV Prevalence^ 40% Uninfected 7% Spontaneous clearance 40% Treated, cleared 3% Treated, infected 10% Untreated, infected n=42

For more information contact: dsilk@kirby.unsw.edu.au

•

•

•

•

In March 2016, new hep C treatments became available and this had an impact on the numbers of people who commenced hep C treatment. Prior to March 2016, only 2% of people in the study with hep C went onto treatment but this increased to 38% when the new treatments became available.

Having hep C made it more likely that you had significant liver damage, and this was especially true in people aged over 50.

Participants aged 50 years or older, and who attended the follow-up visit with a nurse or doctor were more likely to begin treatment for hep C. People with hep C who were currently injecting drugs were just as likely to commence treatment as people who were not.

(See the charts on these pages for specific results from DASSA Central and DASSA North in South Australia.)

The LiveRLife study has demonstrated that comprehensive liver health screening at drug and alcohol clinics is a good way to screen people for hep C and to help those who are

infected to start treatment.

Having access to the new hep C treatments has had an extremely positive impact on the numbers of clients at drug and alcohol clinics who

commence treatment for their hep C. More project information is available at kirby.unsw.edu. au/projects/liverlife-liverhealth-campaign. v

North DASSA Central 12-13 March2019 March 2019 14-15 PARTICIPANTDETAILS DETAILS PARTICIPANT

46 42

54% 36% Male

Recruited Recruited

44 42

Mean age Mean age

Male

15% 17%

83% 57% Currently

Aboriginal ethnicity Aboriginal ethnicity

CurrentlyOST receiving receiving OST

42%

methadone 42% methadone 50%

22% 33% Unstable housing

Unstable housing

70% 62% Ever been in prison

Ever been in prison

buprenorphine

58% 8%

57% 55% Excessive alcohol use

buprenorphine other

Excessive alcohol use

DRUG USE USE DRUG

HCV HCV

84% 74% Ever tested

48% 57% Ever HCV

50% 43% Tested in

68% 75% Initiated HCV

Ever tested

67% 90%

Injected drugs in Injected in last six drugs months last six months

61% 79%

Injected drugs in Injected drugs in last month last month

Tested the lastinyear the last year

Most commonly Most commonly injected drug in last injected in all last month, drug among month, among all recruited recruited 17% Heroin 29% Heroin 39% Amphetamines 45% Amphetamines 4% Other opioids 3% Other opioids 3% Other

*Ever RNA positive = RNA +ve at POC; RNA –ve at POC & ever treated for HCV; missing POC & self-reported ever RNA +ve *Ever positivepresented = RNA +vefor at POC; RNA –ve POCPOC & ever treated for HCV; missing POC & self-reported ever RNA +ve ^HCVRNA prevalence only those withatvalid result ^HCV prevalence for only those valid POCadditional result NOTE: these datapresented are provisional and maywith change when blood tests are analysed NOTE: these data are provisional and may change when additional blood tests are analysed

Ever RNAHCV +ve* RNA +ve*

Initiated therapy HCV therapy

HCV Prevalence^ HCV Prevalence^ 39% Uninfected 40% Uninfected 15% Spontaneous clearance 7% Spontaneous clearance 33% Treated, cleared 40% Treated, cleared 0% Treated, infected 3% Treated, infected 13% Untreated, infected 10% Untreated, infected n=46 n=42

For more information contact: For more information contact: dsilk@kirby.unsw.edu.au dsilk@kirby.unsw.edu.au

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

3

Immunosuppression Risk Experts call for hep B screening for cancer therapy patients

A

n Australian expert panel of medical specialists have recommended that all people undergoing immunosuppression cancer therapy be screened for hepatitis B. If you have ever been infected by hepatitis B, cancer treatment which suppresses your immune system can allow the virus to reactivate— even if your body had dealt with it successfully before.

Reactivation can lead to liver failure, death or sub-optimal cancer treatment.

This reactivation phenomenon is now well understood among health care providers but until recently, there has been no agreed guidelines for practitioners on the management of hepatitis B under such circumstances.

The risk of reactivation depends on the length and extent of the cancer treatment, the drugs and treatment regimen used, underlying hepatitis B viral activity and the extent of liver disease.

Antiviral therapy is effective and known to prevent reactivation but guidance is needed for practitioners on

the most appropriate way to use it. Over or under usage could lead to unwelcome side effects or hepatitis B reactivation, respectively.

The April 2019 consensus statement – Hepatitis B management during immunosuppression for haematological and solidorgan malignancies – made 27 recommendations including: •

all patients undergoing therapy for blood cancers and solid tumours be tested for hepatitis B infection,

•

the treating haematologist or medical oncologist prescribing cancer therapy be responsible for hepatitis B testing,

•

hepatitis B screening include testing for hepatitis B surface antibody, surface antigen and core antibody,

•

all patients found to have chronic hepatitis B be put on antiviral prophylaxis

•

patients without chronic hepatitis B but have had past infection, be assessed for reactivation risk based

on the cancer therapy regimen,

•

people without previous exposure to hepatitis B do not need antiviral prophylaxis but if they lack hepatitis B immunity, they be offered vaccination six months after completion of cancer therapy and the underlying disease is controlled

The consensus statement recommends antiviral prophylaxis begins as soon as possible without delaying cancer therapy and that all those with chronic hepatitis B be referred to a viral hepatitis specialist for routine assessment.

Guidance is further given on when to stop antiviral treatment and how patients should be monitored.

The statement also recommends that testing, antiviral prophylaxis commencement and cessation for children follow the same approach as for adults.

The consensus statement was prepared by an expert panel of medical specialists in infectious diseases,hepatology, haematology, oncology and paediatrics, and representatives from the Australasian Society for Infectious Diseases, the Gastroenterological Society of Australia (Australian Liver Association), the Haematology Society of Australia and New Zealand, the Medical Oncology Group of Australia, and the Australasian Society for HIV,

Viral Hepatitis and Sexual Health Medicine.

The statement is endorsed by the Australasian Society for Infectious Diseases, Gastroenterological Society of Australia, Haematology Society of Australia and New Zealand, Medical Oncology Group of Australia, and Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine.

You can read the statement in full at bit.ly/2X66xyF. v Cecilia Lim

Photo CC Chapendra [flickr.com /photos/chaparral/

antiviral prophylaxis should start as soon as possible but should not delay cancer therapy,

Image courtesy of the Mayo Foundation for Medical Education and Research

•

This piece first appeared on our blog, HepSay, at hepatitissa.asn.au/blog. Come and visit us there!

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

5

Text? Music? Video?

The need for hepatitis resources in all kinds of formats

D

espite the growing trend towards providing health information online, there is still a need to provide information in other formats.

This was the consensus at the recent hepatitis educators meeting in Sydney looking at digital hepatitis B and hepatitis C resources available in Australia.

immediacy of a brochure handed directly to a client, serving as an opportunity for conversation.

Others highlight the effectiveness of posters as a way of providing information without exposing the audience since it’s hard to

other should be provided to suit different needs and situations. These can include posters, brochures, podcasts, blogs, social media posts, videos and online libraries.

A review of digital resources produced through the 40 Hepatitis B Community

One educator from the Northern Territory pointed out that not everyone in the community is digitally literate or has easy access to online information.

While Australia has one of the highest rates of mobile phone ownership in the world, that doesn’t mean people can all afford the data needed to view and download information.

Because of privacy issues, most people would be reluctant to access hepatitis information via free internet in public libraries or community centres.

Online information can be more private for those with the benefit of home internet access, but some educators point to the advantage of the

6

say who is looking at which poster on a wall full of pinups.

On the whole, the educators agreed that digital resources including social media messages, are effective as part of broader engagement but a variety of formats that support and link to each

HEPATITIS SA COMMUNITY NEWS 81 • April 2019

Education projects carried out between 2016 and 2018, was presented by Rebecca Vassarotti from Hepatitis Australia.

The review found that the projects have “resulted in a significant increase in the number of specific digital resources addressing

hepatitis B available for priority populations”.

It found that the projects produced high quality resources that continue to be used by Hepatitis Australia member organisations, and contributed significantly to increasing the database of information available to the community and improving the understanding of the issue of hepatitis B. A similar review of hepatitis C digital resources from 2016 onwards found that while there is an abundance of hepatitis C resources in English, hepatitis C resources in languages other than English was lacking.

Grace Hogan from Hepatitis Australia, who did this review, suggested including digital literacy training as part of community information and education sessions.

Below are some of the resources highlighted in the hepatitis B digital resources review.

Hep B Side: bit.ly/2FjWUlU The Hep B Side is the only resource that has been

translated into Indigenous languages. Specifically targeted to young people, it is a particularly effective resource when used as part of broader community education settings. The use of song as well as language are key reasons why the resource has been so well received

Making Hep B History: bit.ly/2ZAEOUi This animated video is available in many languages including Tigrinya, Swahili, Nepali, Karen, Farsi, Arabic and English. It is over 7 minutes long but there has not been feedback that this is a barrier to access. Across the different translations, this resource has been viewed over 1,500 times.

Hepatitis B and Mothers to Be (print and audio): bit.ly/2IVsLKQ https://soundcloud.com/hepsa

From Dancing in the Rain Dancing in the Rain & Let’s Talk About Hepatitis B: bit.ly/2INWe9e This story, which is told from the perspective of an African Australian family has been well received and is used by a number of other hepatitis organisations. As well as a video story, there is a booklet that tells the same story. The video has been viewed more than 1,100 times.

This is an example of linking different format resources. At the request of a local hospital, Hepatitis SA produced a Chinese language podcast explaining key issues around hepatitis B mother to infant transmission. A QR code to the podcast was added to printed brochures that were available in the hospital. QR Codes are known to be widely used in Chinese communities.

(continued on p12)

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

7

»

LIVER HEALTH DAY

The Cure is pure gold!

Kurlana Tampawardli 45-47 Tapleys Hill Rd, Hendon Monday, 22 July, 10am–3pm Anglicare Elizabeth Mission 91-93 Elizabeth Way Friday, 19 July, 10am–2pm • Giveaways!

• Free Liver Health Assessments from the Liver Nurse!

PLUS: Win all this! Enter the Raffle!

(Prize draw: Wednesday, 31 July, 2019) 8

worldhepatitisday.org.au HEPATITIS SA COMMUNITY NEWS 81 • April 2019

Talk to a Nurse

Viral Hepatitis Nurses and routine notifications

V

iral Hepatitis Nurses are clinical practice 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 and support GPs who are prescribing medications for hepatitis C, or those accredited to prescribe section 100 medications for hepatitis B. The Viral Hepatitis Nurses are located across the Adelaide metropolitan area and support can also be arranged for people in country areas. The nurses can be contacted directly by patients or their GP.

Central Adelaide Local Health Network, Queen Elizabeth Hospital Phone: Margery (0423 782 415) or Debbie/Rose (0401 717 953) Central Adelaide Local Health Network, Royal Adelaide Hospital Phone: Anton (7074 2194 or 0401 125 361) Northern Adelaide Local Health Network Phone: Lucy (0401 717 971) or Michelle (0413 285 476) Southern Adelaide Local Health Network Phone: Rosalie (0466 777 876) or Jeff (0466 777 873)

Viral Hepatitis Nurses Jeff and Margery

Referral of viral hepatitis notifications The South Australian Public Health Act 2011 requires medical practitioners and diagnostic laboratories to notify SA Health of cases (including deaths) suspected of having or diagnosed with specified infections and diseases. These infections or diseases are commonly referred to as 'notifiable conditions', and include hepatitis B and hepatitis C. From August 2018, the Communicable Disease Control Branch (CDCB) has routinely referred notifications of positive hepatitis C pathology tests to SA Health Viral Hepatitis Clinical Practice Consultants, enabling these specialist nurses to contact GPs diagnosing a patient with hepatitis C, and if required by the GP, provide support for patient follow up with guideline based care, including hepatitis C treatment. From June 2019, the CDCB will now do the same for positive hepatitis B pathology tests.

Patients may also self-refer and contact the Hepatitis SA Helpline on 1800 437 222 for more information. v

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

9

The State of Play in 2019 Treatment rates lagging behind

T

he latest hepatitis C treatment data released by the Kirby Institute in June shows that, since March 2016, an estimated 70,260 people in Australia have commenced treatment to cure hepatitis C. Based on the estimated number of people living with chronic hepatitis C infection at the end of 2015, this represents about 33% who have started treatment. But is this enough to prevent the ongoing deaths each year in Australia from liver disease associated with hepatitis?

The data from the Kirby Institute highlights both the progress and deficiencies in hepatitis C treatment uptake. It is great news to see so many people have commenced treatment, with almost all either having been cured, or on their way to being cured. While this is clearly cause for celebration, the downside is that the number of people taking up treatment to cure hepatitis C is declining to alarming levels.

We know from other sources that the overall downward trend in the number of people commencing treatment has continued beyond the end of 2018, averaging at or below 1,000 people per month in

10

2019, which is well short of the Federal Gvernment’s targets. To address this ongoing decline there needs to be a significant push in primary care to identify patients who may need treatment for hepatitis C and help them achieve a cure.

older age group living with hepatitis C, like Test Cure Live, which Hepatitis SA ran earlier this year, are vital. But community education is only one strategy, and can only achieve so much without support and education by the health sector.

Despite GPs being able to prescribe the current treatments, this report shows only 29% of prescriptions are issued by GPs. Hepatitis Australia estimates that this equates to only 10% of all GPs prescribing hepatitis C treatment. We need to reach 90% of GPs in Australia having written a script for these treatments.

The Australian Government has set hepatitis B and hepatitis C eliminations targets for 2022, which are outlined in the National Hepatitis Strategies. Australia has also signed on to the global elimination targets for 2030. But these treatment targets will not be achieved unless action is taken to increase prescribing in primary care settings.

The Kirby Institute report also shows that while there has been a significant increase in people under 50 accessing the new cures, this is not the case for older people. Analysis made by Hepatitis Australia in 2017 suggests that a large proportion of people living with hepatitis C are now aged over 50, and are not engaged in care for their hep C. Many in this older group may not even be aware of the hep C cures being available, or may simply be putting some health issues down to getting older.

Community education campaigns targeting the

HEPATITIS SA COMMUNITY NEWS 81 • April 2019

It is time for the health sector to come together and help solve this problem. If action is not taken quickly to turn these figures around, Australia risks missing the global targets it has publicly committed to. Much more importantly, people will be missing out on a cure for their hep C, and will be developing—and at risk of death from—serious liver disease for no reason.

You can read the Kirby Institute report at bit. ly/2WS3035. v

A hepatitis snapshot

A

ustralia’s Health 2018, released in June, marks the 16th biennial flagship report on health that the Australian Institute of Health and Welfare (AIHW) has released since it was established in 1987. This latest national report card continues the trend of providing independent, trusted and timely information to the wide range of Australians who use it—the community, policymakers, service providers and researchers.

Among the report’s findings: • Over the last 10 years for which data are available, notification rates for hepatitis B and C have fallen, but rates of syphilis, chlamydia and gonorrhoea have risen. The notification rate of human immunodeficiency virus (HIV) has remained steady.

• Of the 800 deaths attributed to notifiable diseases between 2000 and 2015, the most common diagnoses were influenza (282) and chronic hepatitis C infection (225).

• Hepatitis C rates remain dramatically higher in prisoners than in the general population (see chart).

• “Illicit” drug use was responsible for 42% of the hepatitis B burden, 26% of chronic liver disease burden, and 21% of the liver cancer burden.

• New hepatitis C medicines accounted for the most government spending (see chart).

The full report is available at bit.ly/2RxSyg9. v

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

11

»

(continued from p7)

From Hep B – Get Tested

Hepatitis B: My story: bit.ly/2WPggoR The animated story of Yvonne is a stand out resource that has been particularly well received.

This video is in two parts and the first part has been viewed over 16,000 times and has been distributed through Tonic TV in GP clinics across Australia. Interestingly, part 2 only had 400+ views.

Little Hep B Hero: bit.ly/2KufZGn A rare example of a resource for children. Also available as a children’s picture book in English, Chinese and Vietnamese (see issue 73 of this magazine for more information).

Fast Hep B Facts from SA’s African Communities: bit.ly/2J88wd5 This is an example where the impact of a resource was increased by using community members rather than paid actors.

Hep B – Get Tested: bit.ly/2x69YH2 This short animated Cantonese video was From Little Hep B Hero

developed to show at a Cantonese opera concert.

Engagement with the community revealed that there would be nonCantonese speakers in the audience, so Chinese and English text were added.

Among the resources developed through the hepatitis B projects, this is the only example of a resource that has more than two languages in a single presentation.

You Can Be: bit.ly/2XYTNXR This video was created for Hepatitis NSW as part of the Western Sydney University Digital Storytelling Project 2018. It is a very powerful piece of communication, which conveys factual information that is succinct and easy to understand. v Cecilia Lim & Jen Grant

12

HEPATITIS SA COMMUNITY NEWS 81 • April 2019

Affected by he

Affected by hepatitis C? Photo © S. Allen

Hepatitis C peer educators are available to provide treatment information and support to clients at the following services: Free Fibroscan Clinics (No bookings required) •

Calming the C

•

• Information and support in a confidential, friendly environment • Speak to others who have had treatment • Partners, family and friends welcome

Now meeting at HACKNEY, ELIZABETH PORT ADELAIDE: and PORT ADELAIDE Wonggangga Turtpandi For information, phone 8362 8443 12–2pm 12.30–2.30pm See over for• dates Tuesday, 23 July • Tuesday, 2 July HACKNEY: 3 Hackney Rd

• • •

Tuesday, 27 August Tuesday, 22 October Tuesday, 17 December

Free, after-hours support is available for anyone struggling with addictive behaviour.

The SMART (Self Management and Recovery

• •

•

Tuesday, 17 September Tuesday, 12 November

Training) Recovery group meetings run for 90 minutes each Wednesday, from 5.30pm at 3 Hackney Road, Hackney, in the meeting room at the rear of Hepatitis SA.

Hutt Street Day Centre: 3rd Wednesday of each month, 9.30–11.30am, 258 Hutt St, Adelaide SA 5000 WestCare Services; 4th Thursday of each month, 9.30–11.30am, 11/19 Millers Ct, Adelaide SA 5000 Wonggangga Turtpandiand support • Information Aboriginal Primary Health friendly environment Care Service (Pt Adelaide • Speak to others who hav CNP); 1st Wednesday of each • Partners, family and frien month, 9.30–11.30am, 11 Church St, Port Adelaide SA 5015

Calming

Bookings Now required meeting •

•

at HACKN

Anglicare Elizabeth Mission; and PORT ADE 2nd Friday of each month, information, 9.30am–12For pm, 91-93 Elizabeth phon Way Elizabeth (Bookings See via over for reception in person, or call 8209 5400) Noarlunga GP Plus; fortnightly, Alexander Kelly Dr, Noarlunga Centre SA 5168 (Bookings via Noarlunga CNP Peer, or by calling Rosalie on 0466 777 876)

The program can assist with any problematic behaviours, including addiction to drugs, alcohol, cigarettes, gambling, food, shopping, internet and others. Focus is upon the addictive behaviour, not the substance itself.

For more information, call Lisa on 8362 8443, or visit smartrecoveryaustralia.com.au.

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

13

Tests & Diagnosis Sexual health testing services Emen8, Australia, 2019.

Interactive online map

People living with hepatitis may do so for many years without any symptoms, but the longer someone lives with the virus the more damage will be done to the liver. Hepatitis B and C testing is vitally important so that correct diagnosis and treatment can alleviate this damage. Here we look at what a range of diagnostic tests might look like. What tests might be required?

How can you request a test?

What do they involve? What do the results mean?

For a quick but thorough overview of tests have a look at “What are the different types of blood tests used to detect hep C?” at the Test Cure Live website: testcurelive.com. au/hep-c-tests.

Here are some more resources that might help in how to best communicate with your GP and to demystify the whole testing process...they should all be easily accessed online but if you have any problems please contact us at admin@ hepsa.asn.au.

14

What is an alanine aminotransferase (ALT) blood test?

Medical News Today, Bexhill-on-Sea, 2019. 4p.

A doctor may order an ALT test to look for any problems with liver function. This article describes what the test is used for, what it measures and how to understand the results. bit.ly/alt_testinfo Question builder (for GP visits) Agency for Healthcare Research and Quality, Rockville MD, 2019. Online interactive questionnaire A guide to some useful questions to ask your GP if you’re wanting to talk about a health problem or request any medical tests. bit.ly/gp_questionbuilder

HEPATITIS SA COMMUNITY NEWS 81 • April 2019

Interactive map listing sexual health testing services (focus on men who have sex with men).

This is particularly important in diagnosing hepatitis B. Can also provide information on peer-run tests. bit.ly/emen8testing What does the SGOT blood test mean?

Medical News Today, Bexhill-on-Sea , 2018. 6p. article This test helps to determine how well the liver is functioning by measuring levels of aspartate aminotransferase in the blood. Explains how and why these tests may be performed - and how to understand the results. bit.ly/sgot_tests

Hep B testing for adults (infographic - English) Hepatitis NSW, Sydney , 2017. 2p.

Lab test information US National Library of Medicine, Bethesda, MD, 2018. Online searchable database Search for information on more than 100 lab tests: includes what the lab test is used for, why your doctor ordered it, how the test will feel, and what the results may mean. bit.ly/labtestinfo

Graphic representation of the testing process, what the results might mean and what follow up may be needed. Available in English, Korean, Chinese and Vietnamese. bit.ly/hepbadultinfo Liver function tests Hepatitis NSW, Sydney, 2017 (rev). 3p.

Brief notes about the role of the liver, what liver function tests measure and what the results might indicate. bit.ly/liverfunctiontesting

Fibrosis scan: what is it and how can it help me?

Hepatitis SA, Adelaide, 2015. 3-fold brochure Also known as ‘Fibroscan’.

This brochure explains why you might be asked to have this test, how it feels and what it will tell you. bit.ly/fibroscan_hepsa

April 2019 • HEPATITIS SA COMMUNITY NEWS 81

15

HBV PUBLIC FORUM

16

HEPATITIS SA COMMUNITY NEWS 81 • April 2019

Useful Services & Contacts Hepatitis SA Free education sessions, printed information, telephone information and support, referrals, clean needle program and library.

(08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au Hepatitis SA Helpline 1800 437 222 (cost of a local call) Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card.

Call Hepatitis SA on 1800 437 222 for a referral. beyondblue Mental health information line

Hutt St Centre Showers, laundry facilities, visiting health professionals, recreation activities, education and training, legal aid and assistance services provided to the homeless.

Nunkuwarrin Yunti An Aboriginal-controlled, citybased health service with clean needle program and liver clinic.

258 Hutt St, Adelaide SA 5000 (08) 8418 2500

PEACE Multicultural Services HIV and hepatitis education and support for people from nonEnglish speaking backgrounds.

Lifeline National, 24-hour telephone counselling service.

13 11 14 (cost of a local call) www.lifeline.org.au Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers.

13 14 65

1300 224 636 www.beyondblue.org.au

MOSAIC Counselling Service For anyone whose life is affected by hepatitis and/or HIV.

Clean Needle Programs in SA For locations visit the Hepatitis SA Hackney office or call the Alcohol and Drug Information Service.

(08) 8223 4566

1300 131 340 Community Access & Services SA Alcohol and drug education; clean needle program for the Vietnamese and other communities.

(08) 8447 8821 headspace Mental health issues are common.

Find information, support and help at your local headspace centre 1800 650 890 www.headspace.org.au

(08) 8406 1600

(08) 8245 8100 Sex Industry Network Promotes the health, rights and wellbeing of sex workers.

(08) 8351 7626 SAMESH South Australia Mobilisation + Empowerment for Sexual Health www.samesh.org.au Youth Health Service Free, confidential health service for youth aged 12 to 25.

Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100

Viral Hepatitis Community Nurses Care and assistance, education, streamlined referrals, patient support, work-up for HCV treatment, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for an appointment.

Central: Margery - 0423 782 415 margery.milner@sa.gov.au

Debbie/Rose - 0401 717 953

North: Lucy - 0401 717 971

Michelle - 0413 285 476

South: Rosalie - 0466 777 876 rosalie.altus@sa.gov.au

Jeff - 0466 777 873

Specialist Treatment Clinics 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 or 8222 2081 • Lyell McEwin Hospital: call Michelle on 0413 285 476 or Lucy on 0401 717 971

hepsa.asn.au

2

HEPATITIS SA COMMUNITY NEWS 81 • April 2019