Hepatitis C
Red flags
Consider urgent referral for patients with the following:
- New hepatitis C 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
- Features of chronic liver disease
Hepatitis C can now be treated and cured with antiviral therapy. Most cases of hepatitis C that have positive hepatitis C RNA should be referred for consideration of antiviral therapy. Patients may be referred to Liver Clinics or Infectious Diseases.
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
- Assist in stopping iv non-prescription drugs
- Drug counselling service referral
- Psychologist referral
Medical management
- Monitor for hepatic decompensation
- LFTs, 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 C
- Current hepatitis C treatment regimens are
- Weekly Pegylated Interferon alpha injections and twice daily oral ribavirin (peg-IFN-RBV)
- New regimens are
- Direct acting antiviral agents (DAAs) combinations. These inhibit various enzymes and stop viral replication. These improve cure rates to over 90% and are soon to be made available.
- Side effects of anti HCV drugs are
- Peg-interferon alpha
- Flu-like symptoms, fatigue, insomnia, depression, psychosis, bone marrow suppression
- Ribavirin
- Haemolytic anaemia, nausea, rash
- Peg-interferon alpha
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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