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HCV Prevention, Testing and Diagnosis

​​​​Summary

  • Hepatitis C (HCV) is NOT a vaccine-preventable disease.
  • Over 90% of newly acquired HCV infections in Australia are attributable to injecting drug use.
  • Regularly testing patients at risk of HCV provides an opportunity to educate about safe injecting practices and transmission, as well as to diagnose, intervene and prevent progression of liver disease if HCV infection is present.

Quick Facts

  • There were an estimated 230,000 people living in Australia with chronic hepatitis C infection in 2012.1
  • An estimated 58,000 of these have moderate to severe liver disease. 1
  • Over 90% of newly acquired HCV infections in Australia are attributed to injecting drug use.2


Prevention

Currently, hepatitis C (HCV) is not a vaccine-preventable disease.

Regular testing of patients at risk of HCV provides an opportunity to educate about safe injecting practices and transmission. Risk groups for hepatitis C include:

  • people with a history of injecting drug use
  • people who are, or have ever been, incarcerated
  • recipients of organs, tissues or blood products before February 1990 in Australia
  • people with tattoos or skin piercing
  • people born in countries with high HCV prevalence
  •  Aboriginal and Torres Strait Islander populations
  • sexual partners of people with HCV (though the risk of heterosexual transmission of HCV is low),
  • children born to HCV-positive mothers
  • occupational exposure.

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Testing

Testing for hepatitis C involves serological assays and molecular assays.


Diagnosis

The initial screening test to be ordered is the hepatitis C antibody (anti-HCV) test. A positive anti-HCV test indicates exposure to the virus but does not prove current infection.

A qualitative Polymerase Chain Reaction (PCR) test is needed to confirm current infection. A positive PCR confirms the detection of HCV RNA and current infection.

For information on who and how to test and how to interpret serology information, see Decision Making in HCV or The National Hepatitis C Testing Policy

ASHM plays an important role in the National Hepatitis C Testing Policy development. ASHM facilitates the annual review of the policy and manages the National Testing Portal, a website which contains the policy. The portal covers HIV, HBV and HCV testing. Each policy is guided by an Expert Reference Group.


National Hepatitis C Strategy Targets

The Fourth National Hepatitis C Strategy 2014-17 set the following targets to be met by 2017:

  • Reduce the incidence of new hepatitis C infections by 50%.
  • Increase the number of people receiving antiviral treatment by 50% each year.

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Resources

ASHM develops a comprehensive range of practical resources to support the health professionals working with hepatitis C, as well as a series of profession-based booklets for groups most in contact with BBVs and STIs. The resources focus on prevention, testing, diagnosis, management and treatment and are available in printed and/or online formats.

 

Education

ASHM develops and delivers national training curricula, Face-to-face ​and online training, as well as webinars cover prevention, testing and diagnosis.


NSW Laboratories: Best Practice Testing and Reporting of Test Results 

Interpreting HCV Serology and PCR Results in diagnostic HCV testing: Recommended wording for NSW laboratories when reporting HCV diagnostic test results. 

This document was developed for laboratories performing hepatitis C testing for diagnosis and providing comments that are useful to clinicians.

The resource promotes best practice hepatitis C testing and reporting of results to improve diagnosis of hepatitis C infection and improve the understanding and interpretation of hepatitis C serology by requesting doctors.   

The resource is available for download here

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References

1. Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013 2.

2. Lloyd A. Hepatitis C: An Expanding Perspective. Melbourne. IP Communications, 2009:288.

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