Hepatitis B
Red flags
Consider urgent referral for patients with the following:
- New hepatitis B infection with jaundice
- Established cirrhosis with
- GI bleeding (haematemesis, melaena) (send urgently to Emergency)
- Abnormal INR
- Marked weight loss
- Ascites
- Hepatic mass
- Signs of hepatic decompensation (send urgently to Emergency)
- Altered conscious level
- Confusion
- New ascites
- New jaundice
Features that may lead to more urgent categorisation
- Evidence of chronic liver disease
Patients may be referred to Liver Clinics or Infectious Diseases services.
Other important information for referring practitioners
Lifestyle changes
- Encourage healthy nutrition and lifestyle
- May require dietary referral if established cirrhosis
- Avoid constipation if has cirrhosis
- Avoid alcohol
- Assist in stopping iv non-prescription drugs (if relevant)
- Drug counselling service referral
- Psychologist referral
Medical management
- Ensure hepatitis B immunisation for all close contacts of the patient
- Ensure patient is aware of infectivity and availability of hepatitis B immunoglobulin if contact with blood etc by non-immune friends/relatives etc
- Monitor for hepatic decompensation
- Monitor LFT, INR
- Provide education regarding disease and red flags to watch for
- GPs should familiarise themselves with the new anti-viral therapies currently being used to treat Hepatitis B
- Currently Tenofovir and Entecavir
- Perform a medication review in light of reduced hepatic reserve
Referral requirements
A referral may be rejected without the following information.
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
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For login details email:
healthpathways
Login to Brisbane North Health Pathways:
brisbanenorth.