Hepatitis Archives

14 January 2025

Hepatitis C testing rates have tripled in the South Western Sydney region in the past year and treatment rates continue to climb, thanks to a targeted program supporting GPs to identify and care for patients with the chronic health condition. 

With an eight-to-12-week treatment course for hepatitis C now easily accessible – and 95 per cent successful – the increase in testing and treatment rates corresponds with targeted local programs aimed at empowering GPs to manage their patients who have hepatitis C within the practice.  

An important part of that program is the appointment of hepatitis Clinical Nurse Consultants (CNC) who work with GPs and practice nurses to increase the level of testing and treatment. 

These specialist nurses are part of a joint South Western Sydney Local Health District (SWSLHD) and SWSPHN Hepatitis Clinical Support and Quality Improvement Project. 

We spoke to clinical nurse consultant Rachel Wolfenden about the part she plays in treating patients with hepatitis C in South Western Sydney. 

Why did you become a hepatitis CNC? 

I have been a nurse for 10 years and have several years’ experience working as a public health nurse in communicable diseases. I always wanted to focus on blood borne viruses, so this hepatitis C role is ideal for me. I’m deeply committed to promoting health, especially in groups who are often marginalised. With the introduction of oral medicines which can not only treat, but also cure hepatitis C in almost all cases, it’s more important than ever for people, especially those at risk, to get tested. I have been in this role for six months. 

How many different practices/GPs, nurses do you work with? 

Every day I speak with a great group of GPs, practice nurses and practice managers in South Western Sydney about hepatitis C screening and treatment for patients with active infections.   

What sort of support do you provide? How can you help GP practices? 

I work with GPs to ensure patients with positive hepatitis C serology have hepatitis C RNA testing.  I support GPs initiating Direct Acting Antiviral (DAA) oral hepatitis C treatment for non-complex patients, so care can be delivered to patients with hepatitis C within their practice. I help facilitate referrals to the district’s gastroenterology and liver clinics and imaging services for patients with more complex care needs.  

SWSPHN funds five medical centres – called keystone practices – across South Western Sydney to provide hepatitis C treatment for the patients of GPs who are unfamiliar with, or may be hesitant to prescribe, hepatitis C treatment. In my role I link interested GPs and their patients to these practices for hepatitis C work-up and treatment.  

How many patients/GPs has the project helped so far? 

To date the project has followed up on more than 700 hepatitis C notifications (hepatitis C serology and/or hepatitis C RNA positive). This role has provided advice, resources and education sessions to approximately 60 GPs within the district. 

Why is it important GPs reach out to you for advice/support? 

I know how busy a GP’s day can be, so by offering clinical support and resources I help streamline their work. I can help with pre-treatment assessment, clarifying indications for referral to a specialist, and planning oral anti-viral treatment. This gives patients with hepatitis C the best chance to receive the simple, curative treatment that is now available. 

What do you hope to achieve through your role? 

I am committed to Australia’s goal of eliminating hepatitis C as a public health threat by 2030.  My aim is to provide our GPs with the support and resources they need to confidently screen for, and treat, non-complex hepatitis C infections.  

Are there any other information/messages you want to get across to practices? 

Please reach out if you have questions regarding hepatitis C screening and treatment. I can also visit your practice in person. ASHM has an excellent decision-making tool about hepatitis C, and SWSPHN provides clinical guidance on the HealthPathways website. 

What’s the best way for GPs to contact you? 

I can be contacted via email at Rachel.Wolfenden@health.nsw.gov.au, or phone my mobile on 0475 952 636 or the South Western Sydney Public Health Unit on 9794 0855. I can be reached Monday to Friday from 8.30am to 5pm and I am based at the South Western Sydney Public Health Unit, Northumberland Street, Liverpool. 

22 November 2024

Hepatitis C testing rates have tripled in our region in the past year and treatment rates continue to climb, thanks to a targeted program supporting GPs to identify and care for patients with the chronic health condition.

South Western Sydney GPs ranked first in NSW between April and June this year for hepatitis C treatment rates, prescribing 27 treatments, which equates to 54 per cent of total prescribed hepatitis C treatments across our region, according to the latest NSW Health report card.

During the same period, South Western Sydney primary and hospital services combined treated a total of 62 patients in the quarter, bringing the number of treated patients to date to 3,165, which represents a healthcare cost saving of just under $10 million.

The NSW Health report card also highlighted improvements in hepatitis C testing in the tertiary sector while South Western Sydney PHN (SWSPHN) data showed a three-fold increase from 1,077 tests in 2023 to 3,323 in 2024 in the primary care sector.

With an eight-to-12-week treatment course of hepatitis C now easily accessible – and 95 per cent successful – the increase in testing and treatment rates corresponds with targeted local programs aimed at empowering GPs to manage their patients who have hepatitis C within the practice.

As part of a joint South Western Sydney Local Health District (SWSLHD) and SWSPHN Hepatitis Clinical Support and Quality Improvement Project, GPs and practice nurses are supported by a hepatitis Clinical Nurse Consultant (CNC) to increase the level of hepatitis C testing, as well as the treatment of people with hepatitis C.

In turn, Clinical Quality Improvement (CQI) focuses on recall, screening and treatment at-risk populations, as well as existing or newly acquired hepatitis C cases. SWSPHN has also developed a GP brochure which provides essential information and supports capacity building in primary practice.

SWSPHN Chief Executive Officer, Dr Keith McDonald PhD, said the campaign to reduce hepatitis C in the community was an important one.

“It is good to see all the hard work by SWSPHN and general practices in the South Western region having an effect on the numbers,” he said.

“Congratulations on your efforts and on working towards a safer, healthier community for us all.”

The NSW Hepatitis C Strategy, 2022 to 2025, aims to eliminate hepatitis C as a public health concern in NSW by 2028. 

Between 2021 and 2023 South Western Sydney had a 7.4 per cent higher prevalence of hepatitis C than the national average. Campbelltown and Fairfield LGAs have consistently higher rates with 53 per cent and 31 per cent above the NSW average. In 2022, an estimated 7,669 people were living in South Western Sydney with hepatitis C.  

Primary care providers can find out more by:

Downloading the Hepatitis C Toolkit

Community can find out more:

About what we do for community

26 August 2024

Hepatitis C virus (HCV) can be easily cured in 98 per cent of cases with a simple tablet prescribed by a GP, yet more than 7,600 people in South Western Sydney are living with the life-threatening condition – a prevalence 7.4 per cent higher than the national average.

GPs have a crucial role in increasing HCV treatment in our community and in helping meet the national target of hepatitis C elimination as a public health threat by 2030.

There are resources available in South Western Sydney to support you in delivering fast, simple, safe and highly effective treatment to patients who have tested positive to HCV.

Key messages for patients:

HCV can easily be cured:
– in 98 per cent of cases
– in eight to 12 weeks
– with just tablets (direct acting antivirals)
– with little to no side-effects
HCV treatment is covered by Medicare and is available to everyone
Curing HCV clears the virus from the body, reducing liver inflammation and the chance of developing liver cancer, and helping reverse fibrosis and even cirrhosis

HCV treatment information for GPs:

SWSPHN’s website has pages dedicated to detailing the supports available to GPs treating HCV-positive patients in our region, including information about:

training opportunities
the community hepatitis CNC
hepatitis C keystone practices

Visit our website

Information pack:

For GPs who have been notified a patient has tested positive to HCV by the public health unit, SWSPHN has also developed a pack with information on how to support your patient to become hepatitis C-free.

This includes how to:

access clinical guidelines on HealthPathways
contact the Community Hepatitis CNC
discuss your patient’s planned treatment at Project ECHO
access ASHM Hepatitis C Learning Hub
encourage your patient to engage in treatment through the Motivate C Project

Keystone practices:

While you are able to provide treatment, there may be reasons why you would prefer to refer your patient to an alternative treatment provider, such as one of the five hepatitis C keystone practices in South Western Sydney.

SWSPHN funds five GP practices across our region to provide HCV treatment for the patients of GPs who are unfamiliar with or may be hesitant to prescribe hepatitis C treatment.

The keystone practice will complete all medical care required to treat the patient’s HCV. Patients will be advised to see their original GP for all their other healthcare needs.

Specialist treatment services are also available for more complex cases.

Information on how to refer to these services is also available in the information brochure.

Download the pack

02 July 2024

Hepatitis B prescriber training provides general practitioners (GPs) and nurse practitioners with comprehensive training in the best practice management of hepatitis B (HBV), current pharmacology, monitoring and treatment, and the complicating factors surrounding HBV management.

Training is free and eligible GPs and nurse practitioners will be reimbursed $1,650 for their time.

Upon successful completion of this training and the associated case assessment, eligible participants may apply to the relevant NSW health departments for authority to prescribe Section 100 (s100) drugs for the management of HBV in Australia.

What you will learn

the critical role of primary care in the diagnosis, management and treatment of people living with chronic hepatitis B
how to plan long-term care, including guideline-based monitoring and hepatocellular carcinoma screening, for patients with chronic hepatitis B
how to select and prescribe first-line antiviral treatment when clinically indicated
how to identify situations where specialist advice or referral is required
how to integrate principles of person-centred and culturally competent care into hepatitis B management

Training consists of:

online learning modules
three 2-hour interactive webinars via Teams
case studies
multiple choice quiz
presentations and case discussions, delivered by specialists and primary care providers with expertise in hepatitis B.
implementing culturally and linguistically responsive care

Download ASHM’s guide for GPs, other community-based medical practitioners and nurse practitioners on training, accreditation, prescribing and maintenance:
Download [PDF | 12 pages | 485kb]

Entry requirements

you must be a registered medical practitioner
you must work within the South Western Sydney LGAs of Bankstown, Camden, Campbelltown, Fairfield, Liverpool, Wollondilly or Wingecarribee

Why enrol?

gain 11 RACGP/ACRRM CPD hours through self-reported learning
free course
SWSPHN will pay you for the time taken to complete this course (11 hours total training = $1,650) upon completion prior to 30 June 2025. See reimbursement form below.

Next steps

To register your interest please complete this EOI form, then wait for an email with enrolment instructions.

Payment request instructions

Participants must provide the following before 30 June 2025 to ensure payment:

completed consent to appear on prescriber list letter:
Hep B prescriber letter [Word | 1 page | 480kb]
completion certificate
Reimbursement form s100 HBV Prescriber Training [PDF | 1 page | 35kb]

12 June 2024

Hepatitis C (HCV) is a preventable disease due to the high effectiveness of modern treatments and the potential for early detection and intervention. NSW Health is committed to eliminating hepatitis C as a public health concern by 2028, aligning with the World Health Organisation’s (WHO) goal. Central to this effort is the NSW Hepatitis C Strategy 2022-2025, which outlines the comprehensive approach needed to achieve this significant public health objective.

More than 300 Australians die annually from hepatitis C-related causes. As shown in Figure 1, there has been a 93-to-94 per cent cure rate between 2019 and 2022 from the time an individual received treatment. The high cure rates demonstrate the efficacy of hepatitis C Direct Acting Antivirals (DAAs) treatments. By addressing the gap between ribonucleic acid (RNA) confirmation HCV with DAA treatment uptake, Australia can significantly reduce the burden of hepatitis C moving closer to the 50 per cent elimination goal set by WHO.

Screening and diagnosis of hepatitis C

Screening is essential for early detection and treatment effectiveness. Priority populations include:

individuals with a history of injecting drugs
people in custodial settings or with a history of incarceration
those living with individuals who have hepatitis C
people with human immunodeficiency virus (HIV) or hepatitis B
people from culturally and linguistically diverse backgrounds
patients with abnormal liver function tests, acute hepatitis, chronic liver disease or liver cirrhosis
those who have had cosmetic surgery or dental treatments overseas

Resources for screening and diagnosis

Decision Making in Hepatitis C Tool
Guides healthcare professionals on diagnosis, treatment and follow-up

Webinar for GPs
Enhances GP understanding of hepatitis C testing and treatment

Project ECHO
Supports GPs in screening, managing, and treating hepatitis C and liver diseases.

Useful Training
Collection of resources categorised by disease area or profession in ASHIM learning hub

Hepatitis C treatment

Hepatitis C DAAs allow GPs to prescribe effective treatment with a success rate of approximately 95 per cent. DAAs are included in the Pharmaceutical Benefits Scheme (PBS) and are better tolerated by patients. Treatment is between eight to 12 weeks with one tablet a day with minimal side effects.

Resources for treatment

REACH-C Form
Online tool for GPs for timely specialist approval within 24 hours

PBS Information
Details on hepatitis C medication coverage under PBS

Decision-making Tool for Children
Assists clinicians in managing hepatitis C in children

Reducing stigma and discrimination around hepatitis C

Stigma and discrimination significantly hinder treatment access for more than 70 per cent of Australians affected by hepatitis C. These negative attitudes often arise from misconceptions about how the virus is contracted.

To combat this, it is crucial to promote open discussions about liver health and normalise the conversation around hepatitis C. Using inclusive and non-judgmental language fosters a supportive environment, empowering individuals to seek the care they need.

Resources for reducing stigma

The Power of Words: Anti-stigma Guide
Encourages the use of welcoming terms to reduce stigma

Effective prevention strategies for hepatitis C

Prevention efforts in primary healthcare settings include:

promoting safe injection practices and proper disposal of needles
sourcing harm-reduction services such as needle and syringe programs, substance use counselling and opioid treatment programs
educating patients and staff about liver health and hepatitis C

Resources for prevention

NSP Locations and Contact Details
Access local needle and syringe program outlets

The NSW Users and AIDS Association (NUAA)
Supports individuals impacted by drug use criminalisation

Opioid Treatment Program (OTP)
Offers methadone, buprenorphine or suboxone treatment

Empowering patients: resources for hepatitis C support

Motivate C – Treatment Incentive
Motivate C is an incentivised project conducted by the University of Sydney for newly diagnosed hepatitis C patients. The program aims to find out if an offer of a cash reward will encourage people with hepatitis C to seek treatment from community treatment providers. Participants self-register for this study and will be connected with a treatment navigator to guide them through all study procedures. For further information on Motivate C project email project@sydney.edu.au

Patient Pathway Guide
Provides information on testing and treating hepatitis C

Hepatitis NSW Hotline
Offers support and education

Multicultural HIV and Hepatitis Service (MHAHS)
Works with diverse communities to reduce the impact of viral hepatitis

Support from SWSPHN

Keystone practices

The keystone practices initiative is dedicated to enhancing access to essential treatment for individuals diagnosed with hepatitis C. This project ensures both newly diagnosed and existing patients receive comprehensive care and treatment.

GPs across South Western Sydney who are unable to provide hepatitis C treatment or support can refer their patients to one of the five specialised keystone practices. These centres are equipped to provide treatment and management, effectively bridging the gap in hepatitis C management. Once the patient has completed treatment, their care is returned to their regular GP.

For more information and to connect with keystone practices email Rita Colella (LHD Hep C CNC) with the subject: Attention ‘Community Hepatitis C Nurse’. Alternatively, phone 9794 0855 or 0475 952 636 for all required Hepatitis C questions or support.

POLAR walkthroughs

SWSPHN has developed a set of POLAR walkthroughs to assist healthcare providers in utilising the Hepatitis report and Clinic Summary report. These walkthroughs focus on identifying and managing cohorts associated with hepatitis C.

By utilising these walkthroughs and reports, practices can better monitor patient populations, streamline diagnosis and optimise treatment pathways for those affected by hepatitis C.

Helpful walkthroughs:

For more information or support, contact SWSPHN at cqisupport@swsphn.com.au or visit Quality Improvement in Primary Care (QIPC) resources

08 May 2024

Potentially thousands of people in South Western Sydney are living with hepatitis C, a disease which is curable, yet they are unaware of the treatment. Motivate C is a project which offers a cash reward to encourage people affected by hepatitis C to seek treatment from community providers such as their GP.

There is no vaccine to prevent hepatitis C. However, treatment for hepatitis C is now 95 per cent successful.

How common is hepatitis C in South Western Sydney?

In 2020, 0.83 per cent of people in South Western Sydney had hepatitis C, with Campbelltown and Fairfield having the highest rates of disease at 1.18 per cent and 1.01 per cent respectively.

Of that 0.83 per cent – or an estimated 7,669 people – just 42.1 per cent were receiving treatment.

How does the Motivate C study work?

In a bid to support an Australia-wide initiative to eliminate hepatitis C by 2030, SWSPHN is promoting Motivate C, a Sydney University project which aims to find out if a cash reward will encourage those affected to seek treatment from community providers such as their GP.

The study – known as the Methodical evaluation and Optimisation of Targeted IncentiVes for Accessing Treatment of Early-stage hepatitis C (Motivate C) – is offering payments of up to $1,000 (amount decided by computer algorithm) to participants who commence hepatitis C treatment.

It doesn’t matter if you are newly diagnosed or have had hepatitis C for years. The only thing which would prevent you taking part in the study is if you had already started treatment.

About hepatitis C

Hepatitis C is a liver infection caused by a virus which is usually transmitted when blood from an infected person enters the bloodstream of another, either from sharing needles or through sexual activity.

Symptoms can include aches, pain and fever; fatigue; nausea or vomiting; loss of appetite; abdominal pain; jaundice (yellow skin and eyes); mood swings, anxiety and depression.

Most people with hepatitis C don’t experience any symptoms until their liver is irreparably damaged, which can take years.

You are at greater risk of contracting hepatitis C if you:

received blood or blood products before screening improved in 1993
spent a long time on dialysis
have been infected with HIV.

Why is treatment important?

Treatment of hepatitis C is important because it helps stop liver damage and might prevent liver cancer.

Current medicines to treat hepatitis C are safe, effective, easy to take with as little as one tablet a day. Medication is available at low cost for people who have a Medicare card because they are subsidised by the Australian government.

Current medicines are very different from older treatments which often resulted in side effects.

What are the benefits of taking part in the study?

As well as the financial incentive, participants receive the help of a “navigator” to connect them to testing and treatment.

The obvious benefit is they will be cured of their hepatitis C infection.

The project aims to encourage people to get tested, treated and cured of hepatitis C.

Register for the Motivate C Project

Visit the Motivate C Project website to learn more about eligibility and what to expect. If you are unsure whether you have hepatitis C or not, speak to your GP.

Find out more about Motivate C

05 March 2024

Patients at Tharawal Aboriginal Medical Service now have a clearer picture of how healthy their liver is.

Clinical Nurse Consultant, Irena, from South Western Sydney Local Health District’s Hepatology Service visited the Airds centre on Thursday, 29 February and performed 29 liver fibroscans.

The fibroscan sends a pulse through the liver, a bit like an ultrasound, to measure the stiffness of the liver.

This involves putting a probe between the ribs on the right-hand side of the chest and pushing a button which delivers a vibration into the liver.

Stiffness in the liver indicates scarring.

The higher the score, the more likely the liver has fibrosis or cirrhosis.

5 to 7.4 suggests minimal fibrosis
7.5 to 9.4 suggests moderate fibrosis
9.5 or higher suggests severe fibrosis or cirrhosis

Yearly fibroscans are recommended for patients with abnormal liver function tests.

GPs can refer patients to liver specialists at Liverpool Hospital’s Department of Gastroenterology and Liver for:

Fibroscan/Shear Wave Elastography
Viral Hepatitis or other Chronic Liver Disease
Cirrhosis (compensated/decompensated)
Unexplained marked liver function test derangement
Hepatocellular carcinoma (suspected or confirmed)

Referral form templates are available here

CAPTION: Irena performs the quick and painless fibroscan on patient Margaret.

24 July 2023

In the lead-up to World Hepatitis Day on 28 July, SWSPHN has renewed its commitment to the elimination of hepatitis by putting a spotlight on the many hepatitis programs and initiatives we support and endorse.

Our commitment is in line with the WHD 2023’s “We’re not waiting” call to action, and corresponds to an Australia-wide initiative to eliminate hepatitis C by 2030.

With effective treatments available to cure hepatitis C and manage hepatitis B, we encourage at-risk community members to be tested. Tests for hepatitis B and C are not included in standard blood tests and must be requested.

Hepatitis is an inflammation of the liver, commonly caused by a viral infection, and can cause long-term health problems if untreated.

Treatment for hepatitis C, transmitted through blood-to-blood contact, is now 95 per cent successful and there is a vaccine and treatments for hepatitis B.

As part of our undertaking to help eliminate hepatitis, we work with South Western Sydney Local Health District’s Public Health Unit to offer clinics specialising in the care of patients with hepatitis.

We also support Motivate C, a University of Sydney project that aims to find out if an offer of a cash reward will encourage people with hepatitis C to seek treatment by community treatment providers.

Adults with hepatitis C, who haven’t been tested for hepatitis C in the past four weeks, are eligible to take part in the project. Participants self-register for this study and will be connected with a treatment navigator to guide them through all study procedures. All participants are given a compensation payment for their time. Additionally, participants may be randomly assigned to receive a reward payment for starting hepatitis C therapy.

Find out more about Motivate C

Other programs and professionals we work with include:

Liverpool Hospital’s Project ECHO clinic supports GPs to screen, manage, and treat your chronic liver disease and viral hepatitis B and C patients.
Beyond the C is part of the national hepatitis C project, the 50,000 Project, which aims to find the estimated 50,000 people living with hepatitis C who have not accessed treatment, support or care. The partnership program with general practice hopes to engage these people and connect them with care.
ASHM develops and delivers education and training to support the HIV, viral hepatitis and sexual health workforce. ASHM also develops resources to support the HIV, viral hepatitis and sexual health workforce, as well as a series of profession-based booklets for allied health workers and other professionals who may come into contact with blood-borne viruses and sexually transmissible infections.

Talk to your GP about hepatitis B or hepatitis C or call the National Hepatitis Infoline on 1800 437 222 (1800 HEP ABC)

Find out more

21 April 2022

The first step to living a healthy life with HIV and hepatitis C is to get tested. HIV and hepatitis C are treatable health conditions.

If you want to get tested for HIV and/or Hep C and stay anonymous, the dried blood spot (DBS) test is a new, free, easy and private way to test for HIV and hepatitis C.

Just take a few drops of blood from your finger, mail the test back and get your results by phone, text or email.

You don’t need to go to a clinic or see a doctor to do this test.

For more information, to check your eligibility or to get a test sent out to you:

Home – HIV and Hepatitis C Dried Blood Spot Test (nsw.gov.au)

Downloadable resources:

Infographic for print

02 March 2020

Did you know that NSW Health’s Hepatitis B Strategy calls for every pregnant woman to be tested for hepatitis B?

For women diagnosed within antenatal screening, a positive result can be pretty alarming, with issues around:

feeling dirty and contaminated,
worrying about transmission to baby and to other family,
wondering about source of infection (hepatitis B is considered an STI and a diagnosis can raise uncertainty around fidelity within intimate relationships).

In addition, a large proportion of diagnosed women are from culturally and linguistically diverse backgrounds and possibly not highly health literate or comfortable within the NSW healthcare system and environment.

Hepatitis NSW has developed a pamphlet that aims to help address the needs of women diagnosed within antenatal screening.

It was developed with valuable input from Caroline Homer, Professor of Midwifery, University of Technology Sydney, and Hannah Dahlen, Professor of Midwifery, Western Sydney University.

Hepatitis NSW can provide antenatal-related health workers with an ongoing free supply of Hepatitis B, Mothers and Babies. To order your free supply, email pharvey@hep.org.au

Advertise your practice vacancy

Topic: Hepatitis