The Pharmaceutical Benefits Scheme (PBS) listing of direct acting antiviral medications means many people living with hepatitis C can now be treated outside of specialist settings, for example, by their general practitioner in the community.
These medications can be prescribed under section 85 (General Schedule) and non-specialist medical practitioners no longer need to be accredited under the section 100 (Highly Specialised Drugs) program to be eligible to prescribe.
For more information regarding prescribing eligibility criteria and clinical management of hepatitis C, please refer to the following websites:
Non-specialist clinicians can gain experience in the treatment of chronic hepatitis C by treating patients with specialist support, and through participation in hepatitis C training courses offered by the ASHM. For more information, visit the ASHM website.
Viral Hepatitis Nursing Support
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. See the Viral Hepatitis Nursing Support page for more information.
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 will refer notifications of positive hepatitis C pathology tests to SA Health Viral Hepatitis Clinical Practice Consultants, enabling these specialist nurses to contact diagnosing clinicians and if required, offer support to facilitate the follow up of patients and contacts and the provision of guideline based care.
While many patients can now be treated in primary care some patients will require specialist management.
If a patient presents with co-morbidities/features outside the scope of the clinician’s expertise with respect to the treatment of hepatitis C, then the clinician should:
refer the patient to a gastroenterologist, hepatologist, infectious diseases physician or authorised nurse practitioner experienced in the treatment of chronic hepatitis C for specialist management.
These options can be discussed with a Viral Hepatitis Support Nurse.
If a patient wishes to be considered for potential clinical trials for new hepatitis C regimens, they should also be referred to a specialist.
Experienced community clinicians in SA
In addition to specialist gastroenterologists, hepatologists and infectious disease physicians, there are a number of community clinicians who are accredited or experienced in the management of patients with chronic hepatitis C in South Australia. For a list of these clinicians please visit the ASHM website.
Decision making tools
Clinicians can use the following quick reference tools to assist with decision making:
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