Community
intelligence
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- Work with members to seek the views of people from affected communities, including with lived experience, on options to diagnose more people and find people lost to follow up, including through universal hepatitis B screening, point-of-care hepatitis C testing, hepatitis C self-tests, opt-out hepatitis C testing with informed consent, and using information from notification forms to follow-up doctors or their patients
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- Work with ASHM, privacy advisors and through BBVSS to explore how My Health Record, data linkage, clinical management software, medical audit software and notifications data can be used to promote care and engage with people with hepatitis B and hepatitis C who are lost to follow up.
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- Explore with members and through BBVSS the potential for peer contact tracing to help identify the contacts of people with hepatitis B and hepatitis C and work with researchers to design, implement and evaluate peer-led contact tracing models.
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- Work with members to leverage the telehealth exemption that allows a person to consult any medical or nurse practitioner about BBVs without having seen them in person in the prior twelve months to encourage care for people who are not comfortable seeing their regular doctor about hepatitis B or hepatitis C or who are living
in places without convenient access to care.
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- Identify opportunities with members to expand the reach of locally developed education campaigns
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| Easier testing |
- Lead dialogue to identify pathways to the provision of sterile injecting equipment in prisons and other places of held detention
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- Ensure a universal screening program for hepatitis B includes following up testing for hepatitis D among all those diagnosed hepatitis B surface antigen (HBsAg) positive.
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- Recognising the scale and potential of universal screening, explore with members and through BBVSS the public awareness, education and peer navigation and support that members could lead to underpin the program’s success.
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- Explore options to ensure people previously diagnosed with hepatitis B have been tested for hepatitis D coinfection including through My Health Record, data linkage, clinical management software, medical audit software and notifications data.
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- Advocate for hepatitis D RNA testing, which is required to confirm a positive antibody test, to be subsidised through Medicare.
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- Consistent with the advice of the Royal College of Pathologists of Australasia (RCPA), advocate for National Pathology Accreditation Advisory Council (NPAAC) standards to require that every positive hepatitis C antibody test be reflexed to RNA testing so a diagnosis can be given without the need for further phlebotomy.
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- Identify a funding pathway for hepatitis C point-of-care testing to be implemented at its full potential by a range of practitioners, including trained peers, in primary care and community settings.
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- Monitor the development of new hepatitis C point-of-care tests and self-tests and work with industry and other partners to have promising tests submitted for registration by the Therapeutic Goods Administration as early as possible.
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- Promote hepatitis C self-tests once registered and available for sale as a confidential option for people who prefer not to ask a clinician for a test.
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- Facilitate dialogue among members and Commonwealth, state and territory officials on the optimal implementation of dried blood spot testing, once a test is registered by the Therapeutic Goods Administration.
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- Monitor developments and costs in hepatitis C molecular point-of-care testing, noting the future possibility of rapid diagnosis from a finger-prick test at the point-of-care with same-visit treatment commencement.
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Enhanced
surveillance
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- Profile examples of good practice by Public Health Units in following-up notifications of positive hepatitis C antibody tests to ensure RNA testing is undertaken and people with a confirmed diagnosis are supported to commence treatment.
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- Advocate for all hepatitis C RNA test results to be notifiable (so people previously notified as antibody positive who have an RNA negative result can be recognised as having cleared hepatitis C or been cured, and so positive results can inform surveillance and be followed up by Public Health Units).
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- Advocate for the revision and implementation of the 2015 Hepatitis C: CDNA National Guidelines for Public Health Units to remove antibody positivity from the case definition and increase the priority of Public Health Unit follow-up of positive RNA tests so that medical and nurse practitioners are supported to initiate treatment and confirm cure.
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- Work with CDNA’s National BBV and STI Surveillance Subcommittee (NBBVSTISS) to develop a model hepatitis C notification form for better surveillance and service planning.
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- Once hepatitis C RNA test results are notifiable, advocate for the de-notification of new hepatitis C antibody test results to reduce reporting burden.
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