In May, ASHM held the 13th Australasian Viral Hepatitis Conference in Brisbane. ASHM granted several scholarships funded by NSW, ACT and QLD Health, for hepatitis B s100 prescribers to attend the conference. A few recipients have shared their key takeaways in a report back.
Bio: Dr Jasmine Davis is a recently fellowed GP living and working in Mackay, Qld. She has a keen interest in female reproductive health, sexual health and gender affirming care.
Report back: Attending VH2022 was an incredible learning experience, and I was fascinated to hear and read about the interesting work clinicians, peer support workers and researchers have been doing across Australia. Given that the conference coincided with National Reconciliation Week we were called to ‘Be Brave’ and ‘Make Change’ and ensure that as health professionals we are working with our Aboriginal and Torres Strait Islander patients to identify, engage and treat those living with viral hepatitis.
The inspiring work of clinicians undertaking test and treat blitzes for Hepatitis C have motivated me to undertake case finding within our practice, to then offer patients the safe and effective treatments now available. The pre-conference Hepatitis B prescriber update was an excellent refresher, and reminder about improving the follow up and monitoring of people living with Hepatitis B, which I have begun implementing via my clinical software recall systems. Attending a conference that was truly multidisciplinary and gave a voice to people with lived experience was insightful and has encouraged me to attempt to reduce barriers for people seeking care in our clinic.
Bio: Dr Tran Le is a general practitioner who is passionate about chronic disease management. She works in a busy clinic located in Inala (QLD) where there is a high prevalence of chronic viral hepatitis.
I had the opportunity to attend the 13th Australasian Viral Hepatitis Conference held in Brisbane, Queensland. It was great to mingle and see faces in person again rather than via a zoom meeting. The pandemic has been challenging for many, but particularly to our most vulnerable groups including our patients suffering from chronic hepatitis.
Hearing from patients living with chronic hepatitis provided insight to the ongoing stigma and discrimination that challenge them throughout various aspects of their lives such as employment, education, insurance and interpersonal relationships. Though it was inspiring to hear about research achievements within the fields of viral hepatitis B and C, it was also evident that huge gaps remain. There is over representation of our Indigenous and immigrant (particularly Chinese, Vietnamese and African) population in Australia living with chronic hepatitis B, and shamefully an over representation of the hepatitis C population amongst our Indigenous, mental health, IVDU and within custodial settings.
Awareness campaigns alone have not fixed the fundamental issues underlying the stigma and discrimination of viral hepatitis. There needs to be more innovation with regards to harm reduction, support, education and health access. Barriers to hepatitis B and C antiviral treatment remain for Medicare ineligible patients. There is also lack of education and standardised hospital protocols for the management of pregnant women with chronic hepatitis B and their infant in terms of hepatitis B immunoglobulin and immunisation.
Essentially, there is still a lot of work to be done. We need the help of people with viral hepatitis intrinsically involved with policy change and pathway towards cure.
Every death from viral hepatitis is a policy failure.
So what can we do as health professionals? Continue to advocate for our patients. Screen all high risk populations for HBV and HCV. Educate ourselves so we can educate and empower our patients. Liaise with public health networks to organise local outreach liver clinics to reduce transport barriers for patients and provide easier healthcare access. Be culturally respectful and utilise translation interpreter services whenever needed. Offer treatment and become an s100 prescriber for hepatitis B antivirals.
Bio: Dr Evangeline Mazan is a GP working in a small country practice, Laidley Family Doctors in QLD, for the past 5 years. However, has worked in Australia since 2005 after migrating with their family from the Philippines.
Report back: The conference provided a lot of insight on how viral hepatitis can be addressed by different sectors of healthcare. There are people that have been making small changes in communities around Australia. They need all the help they can get to make the results of these small changes affect the wider community. As a GP, I can do my part by actively screening at risk individuals the community and initiating treatment as appropriate. By doing this it could help decrease the patients in the community who are currently undiagnosed and untreated.
There are a lot of research being done with regards to viral hepatitis and this is a good thing. It means that the researchers are finding better ways to help control viral hepatitis. Although I am not a researcher, I can perhaps help in trialling some of the things that they have found out with their studies.
It is interesting to note that there are a lot of success in controlling viral hepatitis in correctional centres. I have worked in a correctional centre, and I can understand how this can be successfully implemented in this setting with enough resource. It is quite satisfying to see individuals get treated successfully whether it be Hepatitis B or C. Sadly I no longer work in this environment because I could have done my part now that I have more knowledge about the disease and how it can be treated.
Having up to date knowledge about viral hepatitis, the treatments available and being aware of the barriers patients have in seeking treatment will help me to adapt my practice in the community. Making sure that Aboriginal and Torres Strait Islander patients and those with a history of IV drug use are not stigmatised but instead given information about viral hepatitis in a way that helps them understand how they can help themselves in addition to stopping it from spreading. I can also make sure that my patients are immunised against hepatitis B. These are only some of the things I can do but I believe that if everyone does a small part then it will all count in the end.
Bio: Jana Van der Jagt is a Hepatology Nurse Practitioner based in Dunghutti Country on the Mid North Coast of NSW with many years’ experience in the field of Viral hepatitis and advanced liver disease and a passion for advocating for marginalised communities.
Report back: I am very grateful to ASHM for their support for me to attend the Viral Hepatitis Conference 2022 in Brisbane.
The highlights for me were the call to arms by Carrie Fowlie, from Hepatitis Australia “How are we tracking against global elimination targets for hepatitis B and C?”. It really re-focussed me on the need to increase testing and engagement in my practice. Another was Jennifer MacLachlan’s presentation on “The cascade of care for women with CHB during pregnancy: progress, gaps and opportunities”. It has prompted me to arrange a series of in-services with our local maternity unit to provide and update and strengthen our connection. I think my favourite session, though, was the lived experience speakers from the NT sharing their stories of the challenges they overcame to access treatment and care for the CHB.
Of course, the networking was fantastic. Left me feeling re-invigorated.
Bio: Cameron Nik is an s100 community GP prescriber based in NSW.
Report back: I had the pleasure of attending and being part of the Viral Hepatitis conference in Brisbane. It was a pleasant experience meeting so many colleagues in one place after pandemic. My main intake was that we are still far away from meeting the targets to manage, control and treat viral hepatitis in Australia. There are many factors involved including lack of enough funding, stigma, lack of awareness in different layers of society and so.
As a s100 community prescribing GP, I was surprised to see the extent of the problem. I feel there are much more needs to be done in this field.
From a personal level, I try to destigmatise/normalise the discussion about these matter in my practice. Also, help them to find a harm minimisation method or strategy if there is no safest option available to them.
