Author: Isabelle Purcell

Ongoing communication summary tool

Patient Name: | | Date:
Address: | |
Phone number: | Email: |
DOB: | |
Medicare Number: | Not eligible? |
Patient | presented for review with | on date:

They have chronic hepatitis B in the following phase:

HBeAg positive chronic infection (immune tolerance) |
HBeAg positive chronic hepatitis (immune clearance) |
HBeAg negative chronic infection (immune control) |
HBeAg negative chronic hepatitis (immune escape) |
ALT |
HBV DNA |
Pregnant, starting immunosuppressing medications or have HIV or HCV Y	N

Below are a series of clinical scenarios.
Identify which of these are relevant to the patient and complete accordingly
SCENARIO 1 (complete if relevant, if not see next scenario)
They are not prescribed any medication, so the monitoring plan is

| | Next Due? | Form given by?
Bloods: LFT, FBE | 6-12 monthly | N/A |
HBeAg / anti-HBe serology | 12 monthly | N/A |
HBV DNA viral load | 12 monthly | N/A |

APRI bloods for cirrhosis detection

HCC surveillance (Liver ultrasound, AFP)

12 monthly

6 monthly

N/A

N/A

SCENARIO 2 (complete if relevant, if not see next scenario)
They are on medication and are prescribed

Entecavir 0.5mg orally daily
Tenofovir disoproxil fumarate 300 mg orally, daily Tenofovir disoproxil maleate 300 mg orally, daily Tenofovir disoproxil phosphate 291 mg orally, daily TAF (non PBS)
Lamivudine Last script given:
Script given this visit for:
Script not given as have enough/ other:

The monitoring plan is

| | Due? | Form given by?
LFT (inc AST), EUC, FBE | 3/6 monthly | N/A |
Serum phosphate (tenofovir only) | 3/6 monthly | N/A |
HBeAg / anti-HBe serology | 6/12 monthly | N/A |
HBV DNA viral load | 3/6 monthly | N/A |
HBsAg/ anti-HBs (if HBV DNA undetectable) | 12 monthly | N/A |
APRI bloods for cirrhosis detection | 12 monthly | N/A |
Cirrhosis assessment (FBE, INR) | 3/6 monthly | N/A |
HCC surveillance (Liver ultrasound, AFP) | 6 monthly | N/A |
SCENARIO 3 (complete if relevant, if not see next scenario)
They have cirrhosis, and will need lifetime HCC surveillance with 6 monthly Liver ultrasound and AFP last done in	due

SCENARIO 4 (complete if relevant, if not see next scenario)
They do not have cirrhosis but need lifetime HCC surveillance as they meet criteria, with a 6 monthly Liver ultrasound and AFP last done	due

SCENARIO 5 (complete if relevant)
They do not have cirrhosis or meet criteria for HCC screening, and will need regular ongoing hepatitis B monitoring with APRI/ Fibroscan®

I have given forms for the next investigations but if lost please reorder as above and cc’ me in any new forms We have covered the following education
Natural history, modes of transmission, and risk reduction
The availability of effective treatments, which are funded by the PBS, if indicated Partner and family immunisation and testing
The need for regular long-term (often lifelong) monitoring - at least annually
Liver health and lifestyle- Alcohol minimisation, smoking cessation, weight management, IDU harm reduction as appropriate Online/ Written Resources
Notes on patient education (including estimated level of patient understanding) 

Bloods should be done 2 weeks prior to appt with a hepatitis B s100 prescriber

Prescription | Pathology | Appointment due:

Next visit s100 
prescriber

N/A

Freq: 3 monthly	/
6 monthly	/ 12 monthly

To consist of:

Due:
Booked? Y	N
Booking contact number for patient:

Hepatitis B s100 prescriber communication status of HBV, adherence, extra monitoring, other symptoms disclosed to follow, if referred to tertiary centre or specialist?

Communication regarding changes in medication/ additional diagnoses/ new allergies/ questions to address from the patient

Regards,

Name Address

ASHM B Referred