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If you have any information, stories, research or news you want to share contact Donna Tilley or Garry Kuchel – the Newsletter Editors.

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World Hepatitis Day: A review of the WHO viral hepatitis strategy 2016-2021

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July 28th is World Hepatitis Day.

This year sees the first ever World Health Organization’s Global Strategy for Viral Hepatitis, which sets a goal of eliminating viral hepatitis as a public health threat by 2030.

Click here to review the draft strategy.

The WHO sets a target to reduce 6-10 million infections to 1 million by 2030. Globally viral hepatitis is on the incline whilst HIV,TB and Malaria are seeing declines.

In Australia, chronic hepatitis B infections sit at around 250,000, with indigenous central Australians being a vulnerable sub-group for viral transmission as well as accessors to vaccination and treatment. Nationally too, our chronic hepatitis C population stubbornly sits at under 250,000 despite highly successful needle exchange programs, the good news for this cohort is that new oral treatments for hepatitis C appear to be well-tolerated and require a shorter course than interferon-based treatments and have cure rates of 90%. Comparatively, hepatitis B treatments are available but need to be lifelong for most people.

In summary the strategy sets 5 key areas of work over the period 2016-2030: vaccination, prevention of mother to child transmission, blood safe practices, harm reduction in IDU populations and treatments to achieving 1 million infections by 2030.

For access to further info on viral hepatitis consider continuing professional development courses via ASHM, sign up for nursing membership at Australian Hepatology Association, of particular clinical use is a free download copy of AHA consensus-based nursing guidelines for the management of viral hepatitis and don’t forget to Love your Liver!

 

Conference

2016 Conferences in HIV and Hepatitis

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News updates from ASHM

CONFERENCES
UNSW: Social Research Conference on HIV, Viral Hepatitis & Related Diseases
31 March-1 April 2016
SYDNEY, AUSTRALIA
margins & belonging: marginalised people building community
Stigmatised sexual and drug practices, and their associated infections and illnesses, produce specific forms of marginalisation for affected individuals and groups. But people in affected groups also forge a sense of belonging and community membership in a range of ways within broader society and within their affected communities. Earlybird Registration closes 1st Feb. Conference Website

INHSU: The 5th International Symposium on Hepatitis Care in Substance Users
7-9 September 2016
OSLO, NORWAY

This leading International conference is focused on the management of hepatitis among substance users. It is now an annual symposium to keep pace with rapid development of new therapies and exciting new research on HCV care among people who inject drugs. Stay up-to-date with conference news by joining the mailing list

APSAD 2016
30 Oct-2 Nov 2016
SYDNEY, AUSTRALIA

The Australasian Professional Society on Alcohol and other Drugs are pleased to invite you to Sydney for the APSAD 2016 Conference, which will feature an exciting program of international and national speakers. The Conference program will explore the individual, cultural, political, social and other contexts critical to effective prevention and treatment, through poster presentations, symposia, keynotes and concurrent sessions.

The Australasian Viral Hepatitis Conference
29 Sep-01 Oct 2016¬¬
GOLD COAST, QUEENSLAND

This is the most important year in Australasian viral hepatitis and there will never be a moment like this in our field again – exciting times for patients, carers and professionals alike. The multi-disciplinary nature of the conference ensures that all in the sector will gain valuable information and networking opportunities from attending. Andrew Hill from the University of Liverpool, UK has confirmed as a keynote speaker. More will be advised soon. Sign up for the newsletter.

Australasian Sexual Health Conference
14-16 November 2016
ADELAIDE, SOUTH AUSTRALIA

It’s time to turn everything you know about Sexual Health on its head and ‘Rethink Sexual Health’
Speakers confirmed:
Associate Professor Amber D’Souza, John Hopkins University, USA
Professor Mark Hayter, Hull University, UK
Associate Professor Rebecca Guy, The Kirby Institute, Australia
Associate Professor Marion Saville, Executive Director of VCS Incorporated, Australia
For updates, Sign up to the newsletter
Visit the website

Australasian HIV&AIDS Conference 2016
16-18 November 2016
ADELAIDE, SOUTH AUSTRALIA

Reposition your thinking, reflect on your practice and reignite your passion at the Australasian HIV&AIDS Conference 2016 (27th Annual ASHM Conference).
Speaker confirmed: The conference organisers are pleased to announce that Professor Sheena McCormack, Professor of Clinical Epidemiology Imperial College London (ICL) will be presenting. More speakers to be confirmed in March. Sign up to the newsletter

PrepPill

EPIC-NSW: Launch of large new PrEP trial in NSW

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This week the NSW Health Minister Jillian Skinner announced the funding of a new clinical PrEP trial called EPIC-NSW.

The trial is supported by_NSW Health and it will be steered by The University of NSW’s Kirby Institute. It is expected that the trial will enroll 3700 people.

In collaboration with ACON and ASHM, The NSW Sexual Health Infolink (SHIL) commenced taking calls from interested candidates this week. SHIL can assess eligibility, register interest and refer to local s100 prescribers & testing services in NSW.

It is important to note that PrEP will not be available to all who may want it through EPIC-NSW. It is believed that by targeting PrEP to those most at risk of HIV, the greatest reduction in HIV transmission can be achieved.

SYDNEY, AUSTRALIA - NOVEMBER 30:  The Sydney Opera House is lit up red ahead of World AIDS Day 2010 on November 30, 2010 in Sydney, Australia. More than 80 iconic landmarks across 13 countries will join (RED) to promote awareness of the ongoing fight against the AIDS epidemic, by turning red to mark World AIDS Day on December 1.  (Photo by Don Arnold/Getty Images for RED)

World AIDS Day 2016: NSW

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WAD
On 1st December 2015 the NSW Health Minister Jillian Skinner launched the NSW HIV Strategy for 2016-2020.

The goals of the strategy are:
-To virtually eliminate HIV transmission in NSW by 2020
-To sustain the virtual elimination of HIV transmission in people who inject drugs, sex workers and from mother-to-child.

For more details visit the NSW Health website: http://www.health.nsw.gov.au/endinghiv/Publications/nsw-hiv-strategy-2016-2020.PDF

Hands

The ADOPT Project: Patient Delivered Partner Therapy (PDPT) for treatment of Chlamydia

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The ADOPT project will look at the feasibility of PDPT for chlamydia as standard clinical practice. In the evaluation, ADOPT will also identify a potential PDPT model. At present the selected services in the study are Illawarra Sexual Health Centre, Liverpool Sexual Health Centre, Sydney Sexual Health and Western Sydney Sexual Health Centre.

Patients eligible for PDPT are:
Only patients with a laboratory diagnosis of oral-pharyngeal or ano-genital chlamydia.
Heterosexual patients with partners who are unable or unlikely to seek clinical services in a timely manner.

Further info can be found here: http://stipu.nsw.gov.au/public-sector-resources/patient-delivered-partner-therapy-adopt/

Thinking about Toxicity and Tolerability

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Today’s plenary session included a talk provided by Dr Patrick Mallon titled ‘ Why should we switch for Toxicity?’. While this talk very much spoke to those who prescribe antiretroviral therapy it did highlight some key points that nurses seeing HIV patients should be aware of. Dr Mallon also did a great job in presenting the information in a way that all clinicians involved in HIV care not just the prescriber should have an awareness of the role of toxicity and tolerability when talking with our clients about their satisfaction with their regime and adherence. Key points that Dr Mallon discussed that apply to nurses providing HIV care included:

– The key differences between tolerability and toxicity: Tolerability is subjective as this is what our clients report. In contrast, toxicity is somewhat more difficult to assess as it is only detected though monitoring hence prescribing clinicians need to determine what toxicities they should be monitoring for.

He gave a great example here from a study that examined patients on a regime that included a placebo. Patients were on regimes, which either included Efavirenz, or a regime including a placebo. As patients didn’t know whether they were being given Efavirenz or not they were warned about the potential for nightmares. Interestingly 10% of the patients on the placebo reported nightmares, which highlighted the role of subjective toxicity.

– Treatment for life and what patients want: Research has shown patients want single tablet regimes and that their satisfaction plays an important role in their ability to tolerate adverse events (which would otherwise be considered toxicity). However, some patients may tolerate such events better due to their satisfaction with the regime.

– The drop versus switch debate: Prescribers need to ensure they take a holistic approach when considering what approach to take with those patients experiencing toxicities. Does the drop or switch outweigh the proposed benefits? The example given was in regards to a study where patients were switched regimes due to concerns about decreasing bone mineral density. This switch resulted in saving 3 years of bone mineral loss but in an era where patients are moving towards being on treatment for life is this actually a significant change? In addition does if such a change is to result in significant increases in costs or decreased patient satisfaction – does it outweigh the benefits?

As nurses we play a key role in assessing our clients adherence and satisfaction with their regimes. This talk highlighted some key points we need to consider when talking with our clients about their regime. At times we are an additional link between our clients and their prescribers hence having an awareness of such issues will assist us further in advocating for our clients.