Print ID P1719 Version 3.0 date 10/09/2019

Chronic Hepatitis C Referral Pathway

Potential Risk Factors

Identified [1]

Unexplained abnormal liver function tests or unexplained jaundice

Pre-testdiscussion &

Informed Consent

Pathology Collected – HCV

Antibody

HCV Ab INTERMEDIATE

HCV Ab POSITIVE

HCV Ab NEGATIVE(Does not have hepatitis)

Inform client and post-test

discussion

Repeat at 1-2 months if acute infection suspected

Further Pathology Collected

– HCV RNA PCR – E/LFT’s

HCV RNA PCR POSITIVE

HCV RNA PCR NEGATIVE

Active Infection

Inform client and post-test discussion

With clients consent refer to:Blood Borne Virus & Sexual Health Service

with relevant pathology to further assess liver disease(see over page)

Likely past infection with viral clearanceOR if liver enzymes abnormal

possible low viral loadRepeat HCV RNA in 6 months

if infection still a concern

Repeat at 1-2 months if acute infection suspected

1. Testing is indicated for people who have risk factors associated with transmission of HCV. In appropriate clinical circumstances, the absence of declared risk factors should not preclude HCV testing. These risk factors include, but are not limited to:

- People who are or have ever been incarcerated - People who have ever injected drugs - Aboriginal and Torres Strait Islander populations - People born in countries with high HCV prevalence

Central Queensland Hospital and Health Service

Print ID P1719 Version 3.0 date 10/09/2019 Page 2 of 2

Referral Investigations

If the HCV RNA PCR test is POSITIVE

Please complete the followingInvestigations prior to referral to the

Blood Borne Virus & Sexual Health Services

HCV RNA Viral Load & GenotypeHepatitis A IgG

Hepatitis B Serology (HBsAG, HBcAb, HBsAb titre level)Urea & Electrolytes

Full Blood Count Cholesterol & Triglycerides

Coagulation Studies (Including INR)Iron Studies

Alpha Fetoprotein HIV Antibody Screen

Ultrasound of Abdomen and

Acoustic Radiation Force Impulse Test (ARFI)

All information contained in this sheet has been supplied by appropriately qualified professionals. It is a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your health. Central Queensland Hospital and Health Service Blood Borne Virus & Sexual Health Service Phone (07) 4932 5440 Fax (07) 4932 5445 Web www.cq.health.qld.gov.au This document was reviewed in April 2019, Version 2.0 Reviewed by: BBV&SHS Published by Central Queensland Hospital and Health Service, Department of Health © The State of Queensland (Central Queensland Hospital and Health Service) 2015, creativecommons.org/licenses/by/3.0/au

Please forward the completed referral to:

Blood Borne Virus & Sexual Health Services 92 Bolsover Street Rockhampton PO Box 4040 Rockhampton Queensland 4700

Reception Phone: (07) 4932 5440 Fax: (07) 4932 5445 Email: 92BolsoverRockhampton@health.qld.gov.au

Dr Paul Clark Consultant Hepatologist

Dr Rudyard Yap Infectious Diseases Physician

Candise Bradshaw Nurse Unit Manager

Melany Day Clinical Nurse

Mary-Ellen Booker Clinical Nurse

Jethro Romer Clinical Nurse

Gary Wright Clinical Nurse