Hep B screening policy launched
INADEQUATE rates of diagnosis and an increasing liver cancer burden have prompted the development of Australia’s first National Hepatitis B Testing Policy.
A third of the estimated 170,000 people who have the disease are undiagnosed and the policy – developed by the Australasian Society for HIV Medicine (ASHM) – advises GPs to specify three tests.
Launched at the Australasian Viral Hepatitis Conference in Auckland this week, it says opportunistic testing of at-risk individuals should include hepatitis B surface antigen (HbsAg), core antibody (anti-HBc) and surface antibody (anti-HBs) to best determine a patient’s immune status and if they have active infection.
“This avoids missed diagnoses, unnecessary vaccination and recalling patients or adding tests,” the policy says.
Infectious diseases physician Dr Benjamin Cowie, from the Victorian Infectious Diseases Reference Laboratory, said it was common to do the surface antigen test only.
“If a GP writes ‘hepatitis B serology’ on the request form it is really up to the laboratory what test they do... but it is really not enabling the GP to get a sense of their status in terms of hepatitis B more broadly,” he said.
ASHM’s clinical director – viral hepatitis, Professor Robert Batey, said it was important to note Medicare rebates were available for the tests and for HBV DNA in asymptomatic patients if it is considered ‘reasonably necessary’ according to the patient’s individual circumstances, such as being from a priority population. Dr Cowie said to get the rebate, clinical notes must specify that chronic hepatitis B is suspected.