TESTING AND MANAGEMENT. Dr Nicole Allard GP Cohealth, Joslin Clinic, West Footscray PhD student, Epidemiology Unit VIDRL

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "TESTING AND MANAGEMENT. Dr Nicole Allard GP Cohealth, Joslin Clinic, West Footscray PhD student, Epidemiology Unit VIDRL"

Transcription

1 TESTING AND MANAGEMENT Dr Nicole Allard GP Cohealth, Joslin Clinic, West Footscray PhD student, Epidemiology Unit VIDRL

2 Disclosure and acknowledgments No conflicts of interest Board Member of Hepatitis Victoria Advisory capacity State Government and ASHM Acknowledgement: ASHM Advanced Management of Hepatitis B course for GPs A/Prof Ben Cowie Jennifer MacLachlan

3 TESTING AND DISCLOSURE

4 Who should we test? People born in intermediate and high prevalence countries Aboriginal and Torres Strait Islanders Family members of people with Chronic Hepatitis B(CHB) Individual or family members with history of liver cancer or cirrhosis All antenatal women Ref: ASHM: National testing policy

5 Who should we test? People living with Hepatitis C or past infection Other indigenous populations, MSM, history of injecting drug use, Tattoos, liver disease, people in custodial settings or have been in custodial settings, health care workers, sex workers, dialysis patients, patients with a history of immunosuppression including HIV infection, prior to biologics or chemotherapy and pre transplantation Ref: ASHM: National testing policy

6 Before the test: informed consent Pre test counseling: informing the patient of the reason for testing and the implication of the test result In certain groups where prevalence is higher and likelihood of the test being positive is higher then need to spend extra time and care to use appropriate language. Ref: ASHM: National testing policy

7 What tests should we order? If chronic infection HBsAg anti-hbc (= HBcAb) anti-hbs (= HBsAb) DON T order HEPATITIS B SEROLOGY In suspected acute infection IgM anti- HBc

8 Interpreting tests If HBsAg positive = Person has hepatitis B (If HBsAg negative does not have hepatitis B) Anti-HBc= exposure to HBV Anti-HBs= immunity If from high or intermediate prevalence country and HBsAg positive it is most likely to be chronic infection

9 HBsAg anti-hbc anti-hbs Interpretation of HBV Serology negative negative negative susceptible HBsAg anti-hbc anti-hbs negative positive positive resolved HBV infection HBsAg anti-hbc anti-hbs negative negative positive vaccinated HBsAg anti-hbc IgM anti-hbc * anti-hbs positive positive positive negative (high titre)* acute HBV infection* HBsAg anti-hbc IgM anti-hbc * anti-hbs positive positive negative negative chronic HBV infection* HBsAg anti-hbc anti-hbs negative positive negative various possibilities Mast 2006

10

11 Conveying positive results Use an interpreter where appropriate providing information about the legal considerations around disclosure of hepatitis B status and the provision of information about (and referral to) available to support services Deliver information in more than one form (resources HepB help, ASHM, Cancer council, hepatitis organisations) Arrange for follow up appointment to answer questions and to review further testing and check understanding ASHM website

12 Workplace Sexual partners Family and or household members Patient living with CHB Friends & Community Sporting club Childcare centre or school

13 Negative results If negative and not immune offer vaccination BUT NOT ALWAYS FREE Ref: The Australian Immunisation handbook 10 th edition 2013

14 Notification to health departments Notification by laboratories all states and territories Notification by clinicians The patient does not have to consent to notification (privacy act) Ref: ASHM 2014 B positive: All you need to know about hepatitis B a guide for primary providers

15 Contact tracing All family members and close household and sexual contacts should be offered testing screening and vaccination if susceptible. In the case of antenatal women need to think about post natal care and the child needs follow up at 12 months Primary care providers are not always well equipped to do contact tracing Keep working at it over time households change Conflict between privacy of the patient and duty to a third party a practitioner can refer case to health department.

16 ASSESSMENT, MONITORING AND TREATMENT

17 Clinical questions Tests How active is the virus? Is there evidence of liver disease? HBeAg, anti- HBe, Viral Load (HBV DNA) Prothrombin time (? Lengthened) Platelet count (?decreased) Albumin (?low) AST/ALT ratio (?reversed) Ultrasound (? Cirrhosis, portal HT) FibroScans (?Fibrosis) Is there any coinfection present? Should they be offered Hepatitis A vaccine? HIV, HCV,HDV HAV

18 FibroScan Clinics Clinics at Monash, Royal Melbourne, Alfred, St Vincent s, Boxhill with 4-12 week wait for appointments (all different forms) Portable machines to certain locations (Health Works, Joslin Clinic)

19 Cancer surveillance Cancer surveillance is part of routine monitoring for specific groups. 6 monthly ultrasound and AFP: African men and women from >20 Asian men for the age of >40 and Asian women from the age of >50 Patients with cirrhosis Patients with a family history of HCC ATSI from 50 years

20 But presents a challenge Community data Ref: Allard 2014 Viral Hepatitis conference 2015 Liver cancer surveillance in primary care: challenges in coordination and care for people from affected communities Kennedy et al: consecutive audits at Flinders Medical centre with system redesign 3 patient and clinician education P r US last 6 months 46% to 92% and over 24 months 0% to 64% e s

21

22 Treatment Antiviral treatment is cost effective as cancer prevention strategy Reduces the risk of cancer by 75% Halts progression of liver disease and reverses fibrosis 2 drugs (tenofovir and entecavir) oral once a day, well tolerated and low resistance profiles at 5 years BUT lifelong treatment Peg Interferon considered HBeAg positive patients Ref: Fattovich, Cohen 2010, Robotin 2010

23 Who needs consideration of treatment? Phase 2 and phase 4 patients ALT> 2 times normal over a prolonged period of time 3-6 months Phase 2 VL >20,000 IU/ml or Phase 4 VL >2,000 IU/ml Anyone with cirrhosis no matter what the viral load or phase Pregnant women HBV VL >= 10, IU/ml (not PBS covered)

24 All patients All patients need yearly viral load and liver function tests done 6 monthly CHB is a dynamic disease changes over time Ideally all should be assessed for cirrhosis using transient elastography FibroScan THERE IS NO SUCH THING AS A HEALTHY CARRIER

25 Management children and pregnant Children women yearly DNA, HBeAg, LFTS paediatric assessment liver cancer and liver failure rare Antenatal women Support and assessment of their health in relation to CHB Viral load (HBV DNA) during pregnancy and referral to specialist service Follow up post pregnancy for management and testing of baby at 1 year

26 .antenatal women 2 Sydney Hospitals 14,857 Births 295 CHB antenatal patients 98% born overseas HBeAg 65% DNA 3.5% Specialist care 7% 3 Victorian hospitals 46,855 Births 398 CHB antenatal patients 87% born overseas HBeAg 33% DNA 20% Specialist care 18% Ref: Guirgis, M JGHF 2009 and Giles et al ANZJOG 2013

27 Minding the gaps Babies born to mothers with CHB not followed up and tested Contact tracing not done more than a third only third adult contacts vaccinated (Williams 2011) Children not always transited to adult care Length of care required challenges specialist and primary care services with lost to follow up in all settings (30% FTA rates)

28 KEY POINTS TESTING SHOULD BE OFFERED TO ALL AT RISK OF CHB ALL PATIENTS WITH CHB NEED REGULAR CARE LONG TERM MANAGEMENT PRESENTS CHALLENGES AND NEEDS WHOLE OF HEALTH SYSTEM APPROACH

29 References The Australian Immunisation handbook 10 th edition 2013 ASHM: National testing policy ASHM 2014 B positive Antenatal guidelines (NSW focus)

30 Resources Hepatitis Victoria Help line HepB Help Cancer Council Help Line The Australian Injecting and Illicit Drug Users League (AIVL) Telephone: The Multicultural Health and Support Service

NOTIFIABLE. Infectious Disease Assessment for Migrants 2015 - 27 - RECOMMENDATIONS. Offer test (HBsAg and anti-hbc) to: Vaccinate:

NOTIFIABLE. Infectious Disease Assessment for Migrants 2015 - 27 - RECOMMENDATIONS. Offer test (HBsAg and anti-hbc) to: Vaccinate: 5.2 Hepatitis B NOTIFIABLE RECOMMENDATIONS Offer test (HBsAg and anti-hbc) to: = All new migrants originating from countries with a HBsAg prevalence of 2% = Household and sexual of identified acute or

More information

Executive summary of recommendations

Executive summary of recommendations MOH CLINICAL PRACTICE GUIDELINES 2/2011 Chronic Hepatitis B Infection College of Family Physicians, Singapore Academy of Medicine, Singapore Singapore Medical Association Executive summary of recommendations

More information

Hepatitis B in Pregnancy

Hepatitis B in Pregnancy Hepatitis B in Pregnancy This guideline was updated in July 2015 by Dr Joana de Sousa, with input from members of the New Zealand Maternal Fetal Medicine Network and Neonatology. Background It is recognised

More information

2015 Outpatient Chronic Hepatitis B Management

2015 Outpatient Chronic Hepatitis B Management 2015 Outpatient Chronic Hepatitis B Management Hepatitis B Hepatitis B Info 70% of acute infections are subclinical More severe symptoms when in addition to other liver disease Fulminant Hepatitis

More information

Viral Hepatitis Case Report

Viral Hepatitis Case Report Page 1 of 9 Viral Hepatitis Case Report Perinatal Hepatitis B Virus Infection Michigan Department of Community Health Communicable Disease Division Investigation Information Investigation ID Onset Date

More information

Molecular Diagnosis of Hepatitis B and Hepatitis D infections

Molecular Diagnosis of Hepatitis B and Hepatitis D infections Molecular Diagnosis of Hepatitis B and Hepatitis D infections Acute infection Detection of HBsAg in serum is a fundamental diagnostic marker of HBV infection HBsAg shows a strong correlation with HBV replication

More information

EPIDEMIOLOGY OF HEPATITIS B IN IRELAND

EPIDEMIOLOGY OF HEPATITIS B IN IRELAND EPIDEMIOLOGY OF HEPATITIS B IN IRELAND Table of Contents Acknowledgements 3 Summary 4 Introduction 5 Case Definitions 6 Materials and Methods 7 Results 8 Discussion 11 References 12 Epidemiology of Hepatitis

More information

William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016

William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016 William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016 Advisory Committee on Immunization Practices (ACIP) The recommendations to be discussed are primarily those of the ACIP composed of 15

More information

ALASKA NATIVE MEDICAL CENTER SEXUALLY TRANSMITTED DISEASE SCREENING AND TREATMENT GUIDELINES

ALASKA NATIVE MEDICAL CENTER SEXUALLY TRANSMITTED DISEASE SCREENING AND TREATMENT GUIDELINES ALASKA NATIVE MEDICAL CENTER SEXUALLY TRANSMITTED DISEASE SCREENING AND TREATMENT GUIDELINES A. Screening Page Chlamydia and Gonorrhea 1 HIV 1 Syphilis 1 Genital Herpes 2 Hepatitis A 2 Hepatitis B 2 Hepatitis

More information

ROYAL HOSPITAL FOR WOMEN

ROYAL HOSPITAL FOR WOMEN HEPATITIS B POSITIVE MOTHERS AND THEIR BABIES This LOP is developed to guide clinical practice at the Royal Hospital for Women. Individual patient circumstances may mean that practice diverges from this

More information

Routine monitoring and assessment of adults with HIV. BHIVA national audit 2015 Aoife Molloy on behalf of BHIVA Audit and Standards Sub-Committee

Routine monitoring and assessment of adults with HIV. BHIVA national audit 2015 Aoife Molloy on behalf of BHIVA Audit and Standards Sub-Committee Routine monitoring and assessment of adults with HIV BHIVA national audit 2015 Aoife Molloy on behalf of BHIVA Audit and Standards Sub-Committee Aim and method Audit adherence to BHIVA guidelines for routine

More information

Infection reports. Acute hepatitis B (England): annual report for Immunisation

Infection reports. Acute hepatitis B (England): annual report for Immunisation Infection reports Volume 8 Number 33 Published on: 22 August 2014 Immunisation Acute hepatitis B (England): annual report for 2013 Introduction Hepatitis B is a blood borne infection of the liver caused

More information

HIV and Hepatitis Co-infection. Martin Fisher Brighton and Sussex University Hospitals, UK

HIV and Hepatitis Co-infection. Martin Fisher Brighton and Sussex University Hospitals, UK HIV and Hepatitis Co-infection Martin Fisher Brighton and Sussex University Hospitals, UK Useful References British HIV Association 2010 http://www.bhiva.org/documents/guidelines/hepbc/2010/ hiv_781.pdf

More information

ALGORITHM FOR SUSPECTED ACUTE VIRAL HEPATITIS

ALGORITHM FOR SUSPECTED ACUTE VIRAL HEPATITIS SEROLOGICAL TESTING FOR SUSPECTED VIRAL HEPATITIS Summary of the Clinical Practice Guideline January 2006 ALGORITHM FOR SUSPECTED ACUTE VIRAL HEPATITIS These recommendations are systematically developed

More information

Document title: Hepatitis B Neonatal and Infant Protocols. Verified by: Matthew Dominey, Screening and Immunisation Manager

Document title: Hepatitis B Neonatal and Infant Protocols. Verified by: Matthew Dominey, Screening and Immunisation Manager South West PHE Screening and Immunisation Team Good Practice Guidance for the management of the NHS Hepatitis B Neonatal and Infant Immunisation Programme Document title: Hepatitis B Neonatal and Infant

More information

HBV DNA < monitoring interferon Rx

HBV DNA < monitoring interferon Rx Hepatitis B Virus Suspected acute hepatitis >>Order: Acute Unknown hepatitis screen Suspected chronic hepatitis >>Order: Chronic unknown hepatitis screen Acute HBV or Delayed Anti HBs response after acute

More information

Hepatitis B Virus (Pregnancy) Investigation Guideline

Hepatitis B Virus (Pregnancy) Investigation Guideline Hepatitis B Virus (Pregnancy) Investigation Guideline Contents CASE DEFINITION... 3 LABORATORY ANALYSIS... 3 BACKGROUND... 4 NOTIFICATION TO PUBLIC HEALTH... 5 INVESTIGATOR RESPONSIBILITIES... 6 STANDARD

More information

Screening for Bloodborne. Unit. A Sarabia MD

Screening for Bloodborne. Unit. A Sarabia MD Screening for Bloodborne Pathogens in the Hemodialysis Unit A Sarabia MD Objectives To review the rationale for bloodborne pathogen screening To review relevant characteristics of bloodborne pathogen infections:

More information

Indicate whether the case had jaundice. If not known or unavailable then select the Unknown option.

Indicate whether the case had jaundice. If not known or unavailable then select the Unknown option. HBC-1 HEPATITIS B, C, NOS Disease name Disease Indicate whether the case is hepatitis B, C or NOS (Not Otherwise Specified). Select hepatitis NOS for cases of hepatitis D, hepatitis E or if the type of

More information

The ABCs of Hepatitis A, B and C Serology Tests: Common Uses in Primary Care. Dr Aaron Woo Consultant Div of Gastroenterology, Dept of Medicine

The ABCs of Hepatitis A, B and C Serology Tests: Common Uses in Primary Care. Dr Aaron Woo Consultant Div of Gastroenterology, Dept of Medicine The ABCs of Hepatitis A, B and C Serology Tests: Common Uses in Primary Care Dr Aaron Woo Consultant Div of Gastroenterology, Dept of Medicine Outline: Clinical Question Approach Clinical Questions, The

More information

2. PROVISION OF COMBINED HEPATITIS A AND B VACCINE OR MONOVALENT HEPATITIS A OR HEPATITIS B VACCINE FOR HIGH RISK GROUPS

2. PROVISION OF COMBINED HEPATITIS A AND B VACCINE OR MONOVALENT HEPATITIS A OR HEPATITIS B VACCINE FOR HIGH RISK GROUPS Guidelines for the Provision of Hepatitis A and B Vaccine to Adults in Western Australia at Risk of Acquiring these Infections by Sexual Transmission and Injecting Drug Use 1. BACKGROUND These guidelines

More information

HBC-1. If the case had jaundice, tick the Yes box. If not, tick the No box. If not known or unavailable then tick the Unknown box.

HBC-1. If the case had jaundice, tick the Yes box. If not, tick the No box. If not known or unavailable then tick the Unknown box. HBC-1 HEPATITIS B, C, NOS Disease Name Disease Indicate whether the case is hepatitis B, C or NOS (Not Otherwise Specified). Use NOS for cases of hepatitis D or E or if the type of hepatitis has not been

More information

Factsheet: New Treatments for hepatitis C Direct Acting Antivirals (DAAs)

Factsheet: New Treatments for hepatitis C Direct Acting Antivirals (DAAs) Factsheet: New Treatments for hepatitis C Direct Acting Antivirals (DAAs) For more information about anything in this factsheet, phone the Hepatitis Infoline on 1800 703 003 or go to www.hepvic.org.au

More information

Hepatitis A, B, C. This material is intended for insurance informational purposes only and is not personal medical advice for clients.

Hepatitis A, B, C. This material is intended for insurance informational purposes only and is not personal medical advice for clients. Hepatitis A, B, C Hepatitis is a general term referring to inflammation of the liver. The usual cause is viral, either Hepatitis A, B, or C. However, toxins and drugs may also induce a hepatitis. The onset

More information

Patient Group Direction for the Administration of Hepatitis B vaccine

Patient Group Direction for the Administration of Hepatitis B vaccine Patient Group Direction for the Administration of Hepatitis B vaccine This PGD must be read in conjunction with the core PGD (Reference: NHSE(LR)/PGD/Core PGD for Immunisations), which details information

More information

Hepatitis C: Tests and Treatments

Hepatitis C: Tests and Treatments This Fact Sheet provides a summary of information about tests and treatment for people with hepatitis C virus (HCV). If you are looking for specific information about treatment with Pegylated Interferon/Ribavirin

More information

What is hepatitis? Sources: WHO. Global Alert and Response. Hepatitis.

What is hepatitis? Sources: WHO. Global Alert and Response. Hepatitis. Viral hepatitis What is hepatitis? Hepatitis is a viral infection that causes inflammation of the liver There are five main types of viral hepatitis: A, B, C, D, E Hepatitis A and E are typically caused

More information

Hepatitis B antenatal screening and newborn immunisation programme. Best practice guidance

Hepatitis B antenatal screening and newborn immunisation programme. Best practice guidance Hepatitis B antenatal screening and newborn immunisation programme Best practice guidance DH INFORMATION READER BOX Policy HR / Workforce Management Planning / Clinical Document Purpose Gateway Reference

More information

Universal Hepatitis B Vaccination in Ireland - Why now?

Universal Hepatitis B Vaccination in Ireland - Why now? Universal Hepatitis B Vaccination in Ireland - Why now? Dr Lelia Thornton April 2008 Background Introduction Epidemiology in Ireland Ireland vs Europe Economic evaluation New schedule Hepatitis B virus

More information

Selective testing for hepatitis A IgG may be cost effective in vaccination candidates? Dr. Fiona Wallace

Selective testing for hepatitis A IgG may be cost effective in vaccination candidates? Dr. Fiona Wallace Selective testing for hepatitis A IgG may be cost effective in vaccination candidates? Dr. Fiona Wallace Northern European Conference on Travel Medicine 5, Bergen, June 2014 Acknowledgements and Declarations

More information

NHS FORTH VALLEY Guidelines for Hepatitis B Vaccination in High Risk Groups

NHS FORTH VALLEY Guidelines for Hepatitis B Vaccination in High Risk Groups NHS FORTH VALLEY Guidelines for Hepatitis B Vaccination in High Risk Groups Approved 01/04/2012 Version 1.0 Date of First Issue 01/04/2012 Review Date 01/02/2014 Date of Issue 01/04/2012 EQIA Yes Author

More information

When an occupational exposure occurs, the source patient should be evaluated for both hepatitis B and hepatitis C. (AII)

When an occupational exposure occurs, the source patient should be evaluated for both hepatitis B and hepatitis C. (AII) XI. OCCUPATIONAL EXPOSURES TO HEPATITIS B AND C RECOMMENDATION: When an occupational exposure occurs, the source patient should be evaluated for both hepatitis B and hepatitis C. (AII) The risk of transmission

More information

The Epidemiology of Hepatitis B and A Infections. Kenrad E. Nelson, MD Johns Hopkins University

The Epidemiology of Hepatitis B and A Infections. Kenrad E. Nelson, MD Johns Hopkins University This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

National Health Burden of CLD in Italy

National Health Burden of CLD in Italy National Health Burden of CLD in Italy 11,000 deaths due to liver cirrhosis or HCC in 2006 Direct costs for the National Health System for treating CLD patients: 420 M / year for hospital care 164 M /

More information

Hepatitis B/HIV coinfection: updates in prevention and care HIV Breakfast Club, Albany Medical Center

Hepatitis B/HIV coinfection: updates in prevention and care HIV Breakfast Club, Albany Medical Center Hepatitis B/HIV coinfection: updates in prevention and care HIV Breakfast Club, Albany Medical Center Elizabeth Reddy, MD, MSc Upstate Medical University Hospital Infectious Disease February 6, 2015 Disclosures

More information

HBV & HCV induced. Liver Cirrhosis Iradj Maleki MD Gut & Liver Research Center Mazandaran University of Medical Sciences

HBV & HCV induced. Liver Cirrhosis Iradj Maleki MD Gut & Liver Research Center Mazandaran University of Medical Sciences HBV & HCV induced Liver Cirrhosis Iradj Maleki MD Gut & Liver Research Center Mazandaran University of Medical Sciences Definition of Cirrhosis Final pathway for a wide variety of chronic liver diseases

More information

HEPATITIS B The Importance of the Hepatitis B Vaccine

HEPATITIS B The Importance of the Hepatitis B Vaccine HEPATITIS B The Importance of the Hepatitis B Vaccine Since 1982, a hepatitis B vaccine has been available to prevent hepatitis B virus infection. Today, the vaccine is made using recombinant DNA technology

More information

Australian Federation of AIDS Organisations (AFAO) Primary Health Care Reform

Australian Federation of AIDS Organisations (AFAO) Primary Health Care Reform Australian Federation of AIDS Organisations (AFAO) Primary Health Care Reform 27 February 2009 1 Introduction The Australian Federation of AIDS Organisations (AFAO) is the peak body for Australia s community

More information

Are Booster Doses of Hepatitis B Vaccine Necessary?

Are Booster Doses of Hepatitis B Vaccine Necessary? Are Booster Doses of Hepatitis B Vaccine Necessary? Current CDC Recommendations And Gaps in Knowledge Division of Viral Hepatitis Centers for Disease Control and Prevention, USA Current United States Recommendations

More information

HBV screening and management in HIV-infected children and adolescents

HBV screening and management in HIV-infected children and adolescents HBV screening and management in HIV-infected children and adolescents Linda Aurpibul M.D. Research Institute for Health Sciences, Chiang Mai University 8% HIV and Hepatitis B Co-infection Among Perinatally

More information

Using Electronic Medical Record Decision Support to Increase Testing for Hepatitis C

Using Electronic Medical Record Decision Support to Increase Testing for Hepatitis C Using Electronic Medical Record Decision Support to Increase Testing for Hepatitis C Camilla S. Graham, MD, MPH Division of Infectious Diseases Beth Israel Deaconess Medical Center None Disclosures Advantages

More information

Transmissible Major Viral Infections Practice Standard. Including Introduction

Transmissible Major Viral Infections Practice Standard. Including Introduction Transmissible Major Viral Infections Practice Standard Including Introduction 1 Foreword Standards Framework for Oral Health Practitioners The Dental Council ( the Council ) is legally required to set

More information

Hepatitis B Pathway stages to protection Actions, roles, responsibilities and standards

Hepatitis B Pathway stages to protection Actions, roles, responsibilities and standards Hepatitis B Pathway stages to protection Actions, roles, responsibilities and standards Start Pathway stages colour code: Action Midwifery role Risk areas Specialist services role Primary care role Paediatric

More information

Summary of hepatitis C among Indigenous Australians

Summary of hepatitis C among Indigenous Australians Australian Indigenous HealthReviews From the Australian Indigenous HealthInfoNet Summary of hepatitis C among Indigenous Australians Australian Indigenous HealthInfoNet Suggested citation Australian Indigenous

More information

Case Finding for Hepatitis B and Hepatitis C

Case Finding for Hepatitis B and Hepatitis C Case Finding for Hepatitis B and Hepatitis C John W. Ward, M.D. Division of Viral Hepatitis Centers for Disease Control and Prevention Atlanta, Georgia, USA Division of Viral Hepatitis National Center

More information

A medical provider guide: Screening for hepatitis C infection in people living with HIV

A medical provider guide: Screening for hepatitis C infection in people living with HIV Living well with hepatitis C and HIV education series A medical provider guide: Screening for hepatitis C infection in people living with HIV Have you diagnosed every case of hepatitis C? Between 1 in

More information

Hepatitis Vaccination Policy

Hepatitis Vaccination Policy Hepatitis Vaccination Policy Purpose To outline requirements for Hepatitis Vaccinations Scope All operational levels of Life Saving Victoria Policy Background Hepatitis is a highly infectious disease.

More information

Offering Testing for Hepatitis B and C in Primary Care

Offering Testing for Hepatitis B and C in Primary Care Offering Testing for Hepatitis B and C in Primary Care Presentation 3 January 2014 Quality Education for a Healthier Scotland 1 Learning Outcomes Participants will be able to:- Undertake a pre-test discussion

More information

Appendix B: Provincial Case Definitions for Reportable Diseases

Appendix B: Provincial Case Definitions for Reportable Diseases Infectious Diseases Protocol Appendix B: Provincial Case Definitions for Reportable Diseases Disease: Hepatitis B Revised Hepatitis B 1.0 Provincial Reporting Confirmed, chronic and probable cases of disease

More information

THE A, B, C S OF HEPATITIS. Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas 75075 (972) 867-0019

THE A, B, C S OF HEPATITIS. Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas 75075 (972) 867-0019 THE A, B, C S OF HEPATITIS Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas 75075 (972) 867-0019 WHAT IS HEPATITIS? Hepatitis means inflammation of the liver

More information

Information about hepatitis C for patients and carers

Information about hepatitis C for patients and carers Information about hepatitis C for patients and carers What is hepatitis C? Hepatitis C is an illness caused by a virus which can be passed through blood from one person to another. It mainly affects the

More information

Hepatitis B. Vaccination

Hepatitis B. Vaccination Hepatitis B Vaccination This material was prepared by the Viral Hepatitis Prevention Board The slides (or subsets) can be reproduced for educational use only, with reference to the original source and

More information

GUIDELINES FOR VIRAL HEPATITIS SURVEILLANCE AND CASE MANAGEMENT

GUIDELINES FOR VIRAL HEPATITIS SURVEILLANCE AND CASE MANAGEMENT GUIDELINES FOR VIRAL HEPATITIS SURVEILLANCE AND CASE MANAGEMENT January 2005 Guidelines for Viral Hepatitis Surveillance and Case Management Ordering information To order a copy of this manual, write to:

More information

Epidemiology of Hepatitis Virus Infections in sub-saharan Africa. Harr Freeya Njai, PhD. MRC Unit, The Gambia

Epidemiology of Hepatitis Virus Infections in sub-saharan Africa. Harr Freeya Njai, PhD. MRC Unit, The Gambia Epidemiology of Hepatitis Virus Infections in sub-saharan Africa Harr Freeya Njai, PhD. MRC Unit, The Gambia 1 Hepatocellular Carcinoma (HCC) One million deaths each year, 5 th most prevalent cancer worldwide

More information

Guidance for hepatitis A and B vaccination of drug users in primary care and criteria for audit

Guidance for hepatitis A and B vaccination of drug users in primary care and criteria for audit Royal College of General Practitioners Guidance for hepatitis A and B vaccination of drug users in primary care and criteria for audit RCGP Drug Misuse Training Programme RCGP Sex, Drugs and HIV Task Group

More information

Impact of natural boostering on long-term protection against hepatitis B after newborn (HBsAg + mothers) vaccination.

Impact of natural boostering on long-term protection against hepatitis B after newborn (HBsAg + mothers) vaccination. Impact of natural boostering on long-term protection against hepatitis B after newborn (HBsAg + mothers) vaccination Roznovsky Ludek Department of Infectious Diseases University Hospital Ostrava, Czech

More information

HEPATITIS C. The Facts. Get Tested. Get Cured! Health

HEPATITIS C. The Facts. Get Tested. Get Cured! Health HEPATITIS C The Facts Get Tested. Get Cured! Health EVEN IF YOU FEEL HEALTHY, HEPATITIS C MAY BE DAMAGING YOUR LIVER. Your liver keeps you healthy in many ways, such as by removing toxins from your blood

More information

Epidemiology of Hepatitis B in Germany

Epidemiology of Hepatitis B in Germany Epidemiology of Hepatitis B in Germany Doris Radun, Robert Koch-Institut, Department of Infectious Disease Epidemiology, Berlin, Germany Viral Hepatitis Prevention Board Meeting Prevention of viral hepatitis

More information

Beginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice

Beginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice Beginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice Dr Chris Ford GP & SMMGP Clinical Lead Kate Halliday Telford & Wrekin Shared Care Coordinator Aims Discuss:

More information

Series of 2 doses, 6-12 months apart. One dose is 720 Elu/0.5ml (GSK) or 25 u/0.5 ml (Merck)

Series of 2 doses, 6-12 months apart. One dose is 720 Elu/0.5ml (GSK) or 25 u/0.5 ml (Merck) UTAH PREVENTIVE CARE RECOMMENDATIONS Adult - Ages 19 and Above IMMUNIZATIONS CONTENTS: General Instructions Hepatitis A Hepatitis B Human Papilloma Virus Influenza Meningococcal A, C, Y, W (MCV4) Meningococcal

More information

POST EXPOSURE PROPHYLAXI S

POST EXPOSURE PROPHYLAXI S Departments of Infectious Diseases & Emergency Medicine POST EXPOSURE PROPHYLAXI S QUI CK GUI DE FOR EMERGENCY DEPT Adapted from Irish National PEP Guidelines and St James s Hospital GUIDE Clinic/Emergency

More information

Management of Chronic Hepatitis B: 2012 Update

Management of Chronic Hepatitis B: 2012 Update Management of Chronic Hepatitis B: 2012 Update Brian J McMahon MD, Liver Disease and Hepatitis Program Alaska Native Medical Center and Arctic Investigations Program, CDC Conflicts of Interest The Liver

More information

Combating Hepatitis B & Hepatitis C in Rwanda

Combating Hepatitis B & Hepatitis C in Rwanda Combating Hepatitis B & Hepatitis C in Rwanda BY MINNIE KARANJA Hepatitis is not a commonplace disease. However, there have been rising cases of Hepatitis B and Hepatitis C infections and related deaths

More information

english facts about hepatitis A, B and C

english facts about hepatitis A, B and C english facts about hepatitis A, B and C What is hepatitis? Hepatitis means inflammation of the liver. Many viruses can cause liver inflammation, including the hepatitis A, B and C viruses. Some people

More information

The Epidemiology of Hepatitis A, B, and C

The Epidemiology of Hepatitis A, B, and C The Epidemiology of Hepatitis A, B, and C Jamie Berkes M.D. University of Illinois at Chicago jberkes@uic.edu Epidemiology: Definitions The study of the incidence and prevalence of diseases in large populations

More information

Epidemiology It is estimated that there are at least 350 million chronically infected cases of HBV worldwide. (see Figure 9.1).

Epidemiology It is estimated that there are at least 350 million chronically infected cases of HBV worldwide. (see Figure 9.1). Chapter 9 09 Vaccine introduced to primary schedule 2008 NOTIFIABLE In some circumstances, advice in these guidelines may differ from that in the Summary of Product Characteristics of the vaccines. When

More information

Chronic Hepatitis B Infection

Chronic Hepatitis B Infection Chronic Hepatitis B Infection MOH Clinical Practice Guidelines 2/2011 Academy of Medicine, Singapore College of Family Physicians, Singapore Singapore Medical Association Gastroenterological Society of

More information

HEPATITIS WEB STUDY Acute Hepatitis C Virus Infection: Epidemiology, Clinical Features, and Diagnosis

HEPATITIS WEB STUDY Acute Hepatitis C Virus Infection: Epidemiology, Clinical Features, and Diagnosis HEPATITIS WEB STUDY Acute C Virus Infection: Epidemiology, Clinical Features, and Diagnosis H. Nina Kim, MD Assistant Professor of Medicine Division of Infectious Diseases University of Washington School

More information

Guidelines for Viral Hepatitis CTR Services

Guidelines for Viral Hepatitis CTR Services Guidelines for Viral Hepatitis CTR Services During the 2007 North Dakota Legislative Assembly, legislation that called for the creation of a viral hepatitis program was introduced and approved. The North

More information

MOTIVATIONS FOR AND BARRIERS TO HIV TESTING IN AUSTRALIA

MOTIVATIONS FOR AND BARRIERS TO HIV TESTING IN AUSTRALIA MOTIVATIONS FOR AND BARRIERS TO HIV TESTING IN AUSTRALIA INFORMATION TO SUPPORT THE REVISION OF THE NATIONAL HIV TESTING POLICY 2006 Rachel Koelmeyer Jeffrey Grierson Marian Pitts The Australian Research

More information

Physician s Guide to. Hepatitis B. a silent killer. Developed by the Asian Liver Center at Stanford University

Physician s Guide to. Hepatitis B. a silent killer. Developed by the Asian Liver Center at Stanford University 2013 Physician s Guide to Hepatitis B a silent killer Developed by the Asian Liver Center at Stanford University Table of Contents Recommended Tests to Screen for Chronic Hepatitis B 2 HBV and Liver Cancer

More information

12/2/2015 HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE OBJECTIVES VIRAL HEPATITIS

12/2/2015 HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE OBJECTIVES VIRAL HEPATITIS HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE DISEASE 101 ONLINE CONFERENCE SARAH WENINGER, MPH VIRAL HEPATITIS.STD.HIV PREVENTION COORDINATOR DECEMBER 3, 2015 OBJECTIVES Describe the populations that should

More information

Lamivudine for Patients with hronic Hepatitis B and Advanced Liver Disease. From : New England Journal of Medicine

Lamivudine for Patients with hronic Hepatitis B and Advanced Liver Disease. From : New England Journal of Medicine Lamivudine for Patients with hronic Hepatitis B and Advanced Liver Disease From : New England Journal of Medicine Volume 351:1521-1531, Number 15, Oct 7, 2004 馬 偕 紀 念 醫 院 一 般 內 科, 肝 膽 腸 胃 科 新 竹 分 院 陳 重

More information

Long-term Results of Pegylated Interferon alfa-2a and Tenofovir for Hepatitis B

Long-term Results of Pegylated Interferon alfa-2a and Tenofovir for Hepatitis B Long-term Results of Pegylated Interferon alfa-2a and Tenofovir for Hepatitis B Patrick Marcellin Viral Hepatitis Research Center Hôpital Beaujon, University of Paris France OBJECTIVES OF THERAPY IN CHRONIC

More information

8. Hepatitis A, B, and C

8. Hepatitis A, B, and C This electron micrograph reveals the presence of hepatitis-b virus HBV "Dane particles", or virions. 8. Hepatitis A, B, and C Prevention: The most effective means to prevent transmission of infectious

More information

Quick guide: Catch-up immunisation for Victoria

Quick guide: Catch-up immunisation for Victoria Quick guide: Catch-up immunisation for Victoria For people with no documentation of previous vaccines Always use the current edition of the Australian Immunisation Handbook for complete advice Department

More information

Hepatitis B vaccination in chronic kidney disease (CKD) patients. J-L. Bosmans F. Van Gompel

Hepatitis B vaccination in chronic kidney disease (CKD) patients. J-L. Bosmans F. Van Gompel Universiteit Hepatitis B vaccination in chronic kidney disease (CKD) patients J-L. Bosmans F. Van Gompel Universiteit 1 Ziekenhuis Universitair Ziekenhuis Background-1 CKD patients are particularly vulnerable

More information

The Hepatitis B virus (HBV)

The Hepatitis B virus (HBV) The Hepatitis B virus (HBV) There are 400 million people in the world who live with chronic hepatitis B, including France. Most people don t even know they are infected. But there are several important

More information

Summary of the risk management plan (RMP) for Harvoni (ledipasvir/sofosbuvir)

Summary of the risk management plan (RMP) for Harvoni (ledipasvir/sofosbuvir) EMA/702765/2014 Summary of the risk management plan (RMP) for Harvoni (ledipasvir/sofosbuvir) This is a summary of the risk management plan (RMP) for Harvoni, which details the measures to be taken in

More information

Briefing Note: Hepatitis B & Hepatitis C. Summary:

Briefing Note: Hepatitis B & Hepatitis C. Summary: Briefing Note: Hepatitis B & Hepatitis C Summary: In Canada, hepatitis B and hepatitis C infections remain serious public health concerns due to high prevalence rates, high health care expenditures and

More information

Hepatitis C Infections in Oregon September 2014

Hepatitis C Infections in Oregon September 2014 Public Health Division Hepatitis C Infections in Oregon September 214 Chronic HCV in Oregon Since 25, when positive laboratory results for HCV infection became reportable in Oregon, 47,252 persons with

More information

UCSF Communicable Disease Surveillance and Vaccination Policy

UCSF Communicable Disease Surveillance and Vaccination Policy Office of Origin: Occupational Health Program I. PURPOSE To provide a sustainable, healthy and safe working environment for UCSF research laboratory staff, and animal research care staff and to prevent

More information

Dr. Abonyi Margit PhD SE 1st Medical Clinic Associate Professor. Hepatology-2014

Dr. Abonyi Margit PhD SE 1st Medical Clinic Associate Professor. Hepatology-2014 Dr. Abonyi Margit PhD SE 1st Medical Clinic Associate Professor Hepatology-2014 Other virus hepatitis Epstein-Barr vírus Cytomegalo vírus Herpes simplex vírus Coxsackie vírus Hepatitis B vírus Hepadnavírus,

More information

1.09 Employee Health Center: Communicable Disease Control

1.09 Employee Health Center: Communicable Disease Control 1.09 Purpose Audience The Employee Health Center (EHC) will provide preventive and healthcare services to UTMB employees for occupationally-related diseases and injuries. The EHC will interact closely

More information

Hepatitis C Epidemiology: 2015 Update

Hepatitis C Epidemiology: 2015 Update Hepatitis C Epidemiology: 2015 Update Vincent Lo Re, MD, MSCE Assistant Professor of Medicine and Epidemiology Division of Infectious Diseases Center for Clinical Epidemiology and Biostatistics University

More information

EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection

EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection European Association for the Study of the Liver Introduction Our understanding of the natural history of hepatitis B

More information

Year 7 & 8 Human Papillomavirus (HPV) vaccination

Year 7 & 8 Human Papillomavirus (HPV) vaccination Department of Health Year 7 & 8 Human Papillomavirus (HPV) vaccination PARENT/LEGAL GUARDIAN: to have your child vaccinated, please Read this information and discuss it with your child Complete sections

More information

Company Overview March 2015

Company Overview March 2015 Company Overview March 2015 Disclaimer This presentation may contain forward-looking statements, including, without limitation, statements containing the words believes, expects, plans, estimates and similar

More information

Viral Hepatitis A, B, and C

Viral Hepatitis A, B, and C Viral Hepatitis A, B, and C What is Hepatitis? Hepatitis means inflammation of the liver Elizabeth A. Bancroft, MD, SM Acute Communicable Disease Control County of Los Angeles Department of Public Health

More information

Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection

Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE PUBLIC HEALTH DRAFT GUIDANCE Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection Introduction: scope and

More information

VIRAL HEPATITIS (A, B AND C)

VIRAL HEPATITIS (A, B AND C) VIRAL HEPATITIS (A, B AND C) Reference should also be made to the NHSGGC policy on BBV testing (April 2013). This can be downloaded from www.nhsggc.org.uk/phpu Hepatitis A,B and C are not notifiable diseases

More information

GENERAL INFORMATION. Hepatitis B Foundation - Korean Chapter Pg. 3 www.hepb.org

GENERAL INFORMATION. Hepatitis B Foundation - Korean Chapter Pg. 3 www.hepb.org GENERAL INFORMATION What is hepatitis B? Hepatitis B is the world's most common liver infection that can lead to cirrhosis and liver cancer. It is caused by the hepatitis B virus (HBV), which attacks and

More information

Patient Information Sheet

Patient Information Sheet Healthcare Worker exposure to a patient s blood What is a healthcare worker exposure? Patient Information Sheet Occasionally, health care workers come into contact with the blood or body fluids of their

More information

Hepatitis C. Screening, Diagnosis and Linkage to Care

Hepatitis C. Screening, Diagnosis and Linkage to Care Hepatitis C Screening, Diagnosis and Linkage to Care Diagnosis If your hepatitis C antibody test is reactive, a second test will be needed to diagnose and determine if you are currently infected. Screening

More information

Bloodborne Pathogens. Safety Guidelines

Bloodborne Pathogens. Safety Guidelines Bloodborne Pathogens Safety Guidelines What are bloodborne pathogens? o Bloodborne pathogens are infectious materials in blood, and other body fluids, that can cause disease in humans. o Hepatitis B virus

More information

1.1.2 Amend the that the Special Authority relating to tenofovir for use in pregnancy for postpartum care;

1.1.2 Amend the that the Special Authority relating to tenofovir for use in pregnancy for postpartum care; Anti-Infective Subcommittee of PTAC Meeting held 1 March 2012 (minutes for web publishing) Anti-Infective Subcommittee minutes are published in accordance with the Terms of Reference for the Pharmacology

More information

Caring for Patients with Chronic Hepatitis B & C

Caring for Patients with Chronic Hepatitis B & C Caring for Patients with Chronic Hepatitis B & C James R. Burton, Jr., MD Associate Professor Medical Director of Liver Transplantation Sections of Hepatology and Liver Transplantation University of Colorado

More information

Hepatitis C. Eliot Godofsky, MD University Hepatitis Center Bradenton, FL

Hepatitis C. Eliot Godofsky, MD University Hepatitis Center Bradenton, FL Hepatitis C Eliot Godofsky, MD University Hepatitis Center Bradenton, FL Recent Advances in Hepatitis C Appreciation that many patients are undiagnosed Improved screening to identify infected persons Assessment

More information

Part Five Screening for Infectious diseases in pregnancy

Part Five Screening for Infectious diseases in pregnancy Patient Pathway: Screening for Communicable Diseases in Pregnancy Screening to occur as early as possible during pregnancy, but can be done at any time, as soon as a woman arrives for care Provide and

More information

Public Health Association of Australia: Policy-at-a-glance HIV/AIDS Policy

Public Health Association of Australia: Policy-at-a-glance HIV/AIDS Policy Public Health Association of Australia: Policy-at-a-glance HIV/AIDS Policy Key message: 1. PHAA supports the primary goal of the Sixth National HIV Strategy 2010-2013 - to reduce the transmission of, and

More information