Hepatitis C information for health professionals

Yes. GPs can treat patients with medication for hepatitis C. Treatment involves prescribing direct-acting antivirals (DAA). These treatments are all oral, usually taken once a day for anywhere between eight and 12 weeks. They are effective in 95% – 97% of patients.³

It may be appropriate to refer some patients to a liver specialist. For example, people who:

• are pregnant
• have another virus such as hepatitis B or HIV
• have taken this medicine before
• have end stage kidney (renal) disease
• have severe liver scarring (cirrhosis)
• have liver cancer
• have had a liver transplant.

You will need to confirm a diagnosis of hepatitis C before prescribing treatment. It’s also important to evaluate whether the patient has any evidence of cirrhosis or other liver conditions. Referral to a liver specialist may be appropriate.

It’s no longer necessary to test for HCV genotypes, as current ASHM recommended hepatitis C treatments are pan-genotypic. HCV genotype is not required by the PBS criteria for prescribing treatment.⁴

People need to be both antibody and PCR positive to confirm a diagnosis of hepatitis C. Antibody positive alone only confirms exposure at some point.

It does not mean the virus is still present in their blood.

Initial diagnosis of hepatitis C can only be confirmed through a PCR test, which shows whether or not the virus is present in the blood.

A PCR test is only undertaken if a previous antibody test has shown the patient has been exposed to the virus.

If a PCR test comes back as positive it may be appropriate to order more tests to check the state of the liver, and viral load.

Yes, treatment is available to all and should be offered to anyone with hepatitis C who want to be cured in a non-judgemental manner.

Treatments not only provide a cure, but they also help to prevent transmission to others. You might want to engage other services that can assist treatment completion.

Any pharmacy can supply hepatitis C medication under prescription. Treatment for hepatitis C is available under The Pharmaceutical Benefits Scheme.⁵

Supply should be available in all geographical areas, but it is probably good to ring your local pharmacy first to make sure they can ensure continuity of access for your patient.

For any queries about pharmacies contact the LiverLine on 1800 703 003.

GPs in Australia do not require additional training to treat patients with hepatitis C. However, for those interested in further training there are a range of options:

• Australian Society for HIV Medicine (ASHM) training
• HealthPathways (to login please email for the username and password)
• HCV Navigate

If the patient has any evidence of liver damage, ongoing monitoring will be required. A referral to a specialist gastroenterologist or hepatologist is recommended.

Some patients may need counselling or support while they adapt to life without the virus. For some people the transition from having chronic hepatitis that may have been present for decades to the position of being clear can be difficult.

The hepatitis C virus is often credited as the cause of physical and psychological discomfort, and any persistence of these symptoms post cure can cause confusion.

Further information for GPs and health professionals can be found here: HEP C Treatment Guidelines