CHAT Cairns Hepatitis Action Team
FOR CLINICIANS
Dr Darren Russell (Cairns Sexual Health Service) and Morag (CHAT) talking together with the Cairns Post 2016
Dr Malcolm MacDonald (Wuchopperen Aboriginal Medical Service), Dr Josh Hanson (Cairns Hospital), and Professor Greg Dore (The Kirby Institute, Sydney), at Cairns World Hepatitis Day, 2015
Need some training or support to prescribe?
Contact Cairns Sexual Health Service 42264769 to book training for your clinic, or to connect with an experienced clinician or specialist to support you while you learn:
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experienced general practitioners and nurse practitioners can now prescribe
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for those new to prescribing you can consult with a specialist
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community pharmacies can dispense
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fully subsidised for all
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8 - 12 weeks treatment for most. Refer to a specialist clinic for cirrohsis
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usual prescription fees apply ($6.80 per month for someone with a Healthcare Card, $39.50 without)
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anyone with hep C is eligible regardless of their level of liver disease
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people who are struggling with addictions are welcome and encouraged to access treatment
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people can be treated more than once, or commence again if they didn't fill a script or complete treatment.
Checklist before prescribing hep C treatments
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Genotype and viral load
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Treatment naïve or experienced
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Cirrhotic? Fibroscan or APRI Score ‘AST to Platelet Ratio Index’ (kPa>12.5; APRI>1) If cirrhotic refer to a specialist clinic.
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Hepatitis B (sAg positive?)
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Renal dysfunction?
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Concomitant medications/drug interactions?
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Many potential interactions Though few are serious
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Beware amiodarone!!
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Check the University of Liverpool Drug Interactions checker or download the app [University of Liverpool HEP iChart]
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Conflicting priorities/adherence?
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Contraception/pregnancy?
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Reinfection? Treat again. Encourage them to bring in a friend for treatment, so that injecting networks are hep C free.
PBS authority approval from the Department of Human Services (Medicare) via written or telephone channels & will be required for each prescription; the medicines will not be available under streamlined authority.
General Statement for Drugs for the Treatment of Hepatitis C PBS
New medications are becoming available, and guidelines are being reviewed frequently. Experienced clinicians review this page regularly on our behalf.