The Hepatitis Prevention Program (HPP) helps people get tested for bloodborne viruses, get treatment and get vaccinated. Our counsellors also provide community education and training on all things hepatitis, including how to refer to the HPP and other community services.
This training session below will cover:
The session will take around 45 minutes to complete. There is a short, comprehensive quiz at the end. Once completed, you will receive a Certificate of Attainment by email.
Hepatitis means inflammation of the liver.
When the liver is damaged by viruses, alcohol, drugs or over-consumption of other toxins, people can develop hepatitis. In less common cases, people can get hepatitis because their immune system stops working properly.
There are 5 viruses known to infect and inflame the liver.
These are hepatitis A, B, C, D and E. The symptoms of all five viruses can be similar. The main difference is the way they are transmitted and the effects they have on people’s health.
The 2 most common types of liver inflammation are hepatitis B and hepatitis C.
According to Hepatitis Australia, approximately 356,655 Australians are currently living with chronic hepatitis B and C. Many more people don’t even know they have hepatitis.
Other types of viral hepatitis are:
This animated cartoon by the World Health Organization (WHO) shows common ways you can get hepatitis and safe practices to avoid it.
Let’s begin by finding your liver. Place your hand on the right-hand side of your abdomen, just below your diaphragm. It is just there, behind your ribs — the largest organ inside your body. It’s about the size of a rugby ball and weighs around 1.5 kilograms.
The liver is responsible for helping with these essential functions:
Perhaps most ingenious of all, the liver is the only organ able to regenerate itself by creating new tissue. So it can still cope with doing all of the above even if it is diseased, just not as efficiently.
To maintain a healthy liver it is important to:
Hepatitis can be acute or chronic.
Liver check-ups are easy, painless and could save your life.
Without treatment, both hepatitis B and hepatitis C risk causing cirrhosis, liver failure or liver cancer. Even if people feel well, they may need testing and treatment if in a high-risk group.
A liver check-up usually starts with blood tests to measure how well the liver is working. The test result enables GPs or specialists to decide the most effective treatment to slow down and reverse liver damage. Check-ups may be necessary every 3, 6 or 12 months.
The video below highlights the importance of regular check-ups, what’s involved, and getting a FibroScan or a liver ultrasound.
Hepatitis A can have serious (but short-lived) symptoms and people generally make a full recovery.
Like hepatitis B and C, hepatitis A is a virus that affects the liver. However, unlike hepatitis B and C, it is transmitted by faecal-oral transmission.
Some of the ways this can happen are:
Hepatitis A is not common in Australia; however, small outbreaks occasionally occur.
Remote Aboriginal and Torres Strait Islander communities with less access to clean water and sanitation are at higher risk. Also when travelling overseas, there is a much higher risk of getting hepatitis A if you are visiting a developing country with less access to clean water or sanitation.
There is a vaccine to protect against hepatitis A.
Not everyone who gets hepatitis A will experience symptoms, especially children under 5 years old. Symptoms can last for several weeks, but most people fully recover and will develop HAV antibodies.
Hepatitis A is very contagious, so if someone has it, they should stay away from child care, school, work or other places where they could spread the infection. A doctor can test to see when the infection has passed.
The blood test looks for 2 different types of antibodies to the virus:
If the test is positive for IgM antibodies and negative for IgG antibodies, hep A infection most likely took place within the past 6 months. The hep A is either in the process of being cleared by the immune system or it is getting worse.
If the test is negative for IgM antibodies and positive for IgG antibodies, either the person was infected with hep A at some time in the past or has been vaccinated against hepatitis A. In either case, they are now immune to the virus.
Hepatitis B is the most common liver virus in the world.
Hepatitis B can be transmitted through:
The most common time people get hepatitis B is early in life. If women are pregnant and have hepatitis B, the baby should get an injection within 12 hours of being born. This injection contains the first dose of vaccine, as well as hepatitis B antibodies that help the immune system to fight the virus. This injection, together with the rest of the vaccine course, is very effective at protecting the baby against hepatitis B.
People can get treatment to manage chronic hepatitis B but not to cure it.
Hepatitis B can not be transmitted through:
Many people with hepatitis B have no symptoms. It’s important to get regular liver check-ups, even if people don’t feel sick.
If someone gets hepatitis B, the body’s immune system will try and fight the virus. There are 2 possible outcomes: people can either get an acute or chronic illness.
Most children don’t get symptoms from acute hepatitis B, but are much more likely than adults to develop chronic hepatitis B.
Among adults, the symptoms for acute hepatitis B can include:
If people have acute hepatitis B, the symptoms might not be very bad and may not last very long. Only a small number of people with acute hepatitis B become sick enough to recognise the symptoms. If they do become very sick, they should see a doctor straight away because it can be life threatening.
Many people with chronic hepatitis B do not experience any symptoms. If they do have symptoms, they could include:
Over time, some of the things that can happen to the liver are:
The table below shows what is likely to happen to babies and children if they get hepatitis B.
|Age||Acute Hep B||Chronic Hep B|
|Infant (<1 year)||Most will not develop any symptoms||90% will get chronic hep B unless given prophylaxis injection and vaccine at birth|
|Child (1 to 6 years)||Most will not develop any symptoms||30% will get chronic hep B|
|Child (>6 years) and adolescent||Most will develop symptoms||Less than 5% will get chronic hep B|
People who are recommended to get the hepatitis B vaccine according to the Australian Immunisation Handbook (ATAGI 2018):
people living with HIV
dialysis patients and people with severely impaired kidney function
people about to receive an organ transplant
people who have received a stem cell transplant
people with chronic liver disease and/or hepatitis C
people who receive certain blood products
people with developmental disabilities who attend day-care facilities
people who work in any occupation that involves direct patient care, handling human tissue, blood or bodily fluids, or used needle and syringes
police, members of the armed forces, emergency services staff, and correctional facilities staff
funeral workers, embalmers
staff involved in the care of people with developmental disabilities
workers who perform skin penetrating procedures, such as tattooists and body piercers
household or other close contacts of people living with hepatitis B
sexual contacts of people living with hepatitis B
men who have sex with men
migrants from countries with higher levels of hepatitis B
people who inject drugs
inmates in correctional facilities
sex industry workers.
Blood tests are used to diagnose hepatitis B. If someone does have the virus, then a GP or specialist may do other tests to check if the liver has been damaged. Tests for hepatitis B are not part of regular blood tests – people have to ask for them.
The table below lists the type of blood tests GPs will use to test for hepatitis B, and what it means if the result is positive.
To understand the tests described below, it might help to know 2 medical terms: antigen and antibody.
|Test||What this shows||Meaning if positive|
|Hepatitis B surface antigen (HBsAg)||Shows if a person currently has a hep B infection||Person currently has hep B, most likely a chronic infection|
|Hepatitis B core antibody (Anti-HBc)||Shows if a person has previously had a hep B infection||Person has previously been exposed to hep B|
|Hepatitis B surface antibody (Anti-HBs)||Shows if a person is immune to hep B||Person can no longer contract hep B|
If a person:
Let's find out if what you think you know, is right!
What's the risk? Can you get hepatitis C from... (Please answer all questions with true or false.)
Hepatitis C is usually spread when a person comes into contact with blood from an infected person.
Hepatitis C can be transmitted through:
Hepatitis C can lead to chronic illness in 75% of people exposed.
If someone does get hepatitis C, the body’s immune system will try and fight the virus. There are 2 possible outcomes: people can either get an acute or chronic illness.
There is no vaccine for hep C; however, people with chronic hepatitis C can be cured with direct-acting antiviral (DSS) medicines. Without treatment, hep C can cause liver disease and cancer.
New medicines used provide a 97% chance of cure. Other genotypes (strains of the virus) can be more difficult to treat and can require combinations of medicine.
Note: Cure is defined as having no presence of the virus immediately after therapy and for 12 weeks afterwards.
People with hep C often do not have any symptoms and often dismiss symptoms as just part of getting older.
If symptoms are present, they can include:
Things to consider
Gender, health history, eating habits, lifestyle, age, stress levels, and alcohol and other drug intake (whether prescribed or illicit) can also affect how you experience living with hep C. Some people don’t get any symptoms.
The only way to know if someone has hep C is to have a blood test.
Tests for hepatitis C are not part of regular blood tests – people have to ask, but they are free for people with a Medicare card.
The table below lists the type of blood tests GPs will order to test for hepatitis C and what it means if the result is positive.
|Test||What this shows||Meaning if positive|
|Hepatitis C antibody test||Shows if a person has been exposed to the hep C virus||Person has previously been exposed to hep C or they have it now|
|Hepatitis C RNA test||Shows if a person currently has hep C||Person currently has the hep C virus. They will need to talk to their GP about getting cured|
Hep C Antibody Test
If someone has previously had hep C, including if they’ve been cured, they will always have hep C antibodies.
People do not need to have another antibody test if they have previously tested positive to hepatitis C antibodies. Having hep C antibodies does not necessarily mean people currently have hepatitis C, and the antibodies do not protect them from getting hep C again.
It can take up to 12 weeks from the time hepatitis C enters someone’s blood until the body starts producing hepatitis C antibodies. So, people may need to have another test if they have caught hep C recently. At some point, about 25% of people who develop hepatitis C antibodies in response to infection clear the virus.
If people test positive for hepatitis C antibodies, they will need to have an RNA test. Some doctors order this at the same time as the antibody test by asking the pathology to do an RNA test if the antibody test is positive.
Hep C RNA test
The RNA test will confirm whether someone currently has the hepatitis C virus. The information is used to help decide their treatment, particularly in regard to genotype 1.
|Test||What this shows|
|PCR genotype test||There are 6 genetic groups known as genotypes. The PCR genotype test looks for the virus and the particular genotype (strain) of hepatitis a person has. Knowing the genotype can help the doctor to work out which treatment will be most effective.|
|Liver function test||This blood test checks liver function. A damaged liver releases enzymes into the bloodstream where they can be detected. This measures the amount of enzymes in the blood to check if the liver is damaged. Damage may be due to hep C or a range of other things, including alcohol and some drugs.|
If 100 people are infected, about 25% will clear the virus completely in 2 to 6 months, but will continue to have hep C antibodies in their blood.
The remaining 75 people who do not clear the virus will develop ongoing or chronic infection and are at risk of developing cirrhosis of the liver.
Of these people who develop chronic hepatitis, about 20 people will not experience any noticeable illness or symptoms.
After an average of 15 years, some people with chronic hepatitis C will experience some symptoms and may develop some liver damage.
After 20 years, 5 to 10 people with liver damage will develop cirrhosis and liver cancer. Between 2 and 5 of these people will experience liver failure or develop a form of liver cancer.
The likelihood that a person will develop cirrhosis and/or liver cancer is most affected by the duration of the infection. However, other factors can affect these risk levels:
Where can people get treatment?
There are new DAA medicines that cure hepatitis C. DAA stands for direct-acting antivirals. GPs can now prescribe the new DAA medicines, but they may ask for advice from a specialist if they do not have a lot of experience treating hepatitis C.
In some cases, people will need to see a specialist to get treatment because of other health problems.
GPs may refer to a specialist if people:
Who can get cured?
Anyone over the age of 15 with a Medicare card can get the medicines at low cost. People shouldn’t take DAA medicines if they’re pregnant.
How will people know if they have been cured?
Treatment is now more than 97% effective at curing hepatitis C.
Being cured of hepatitis C means that treatment has worked, and people no longer have the hepatitis C virus. To check this, a doctor will order an RNA test 12 weeks after treatment and if the results show ‘virus undetectable’ (no virus) this means that it has been cured. It is important to have this final test and not assume people are cured until the results confirm it.
If the hep C is not cured, the doctor may recommend a second course of treatment, usually with different medicines.
Once hep C is cured, the person will always have antibodies. Having hep C antibodies does not mean someone still has hep C – this can only be determined with an RNA test.
Note: If someone does get hepatitis C again, they can be cured again.
What medicines are used to cure hepatitis C?
|Epclusa®||(sofosbuvir + velpatasvir)||1, 2, 3, 4, 5, 6|
|Maviret®||(glecaprevir+ pibrentasvir)||1, 2, 3, 4, 5, 6|
|Vosevi®||(sofosbuvir + velpatasvir + voxilaprevir)||Only used if previous DAA treatment has failed|
The new treatment is easy to take with as little as one tablet a day, no injections, and most people experience few to no side effects. People will need to take 1 to 3 tablets for 8 to 12 weeks, depending on which medicine is being used. The above DAA medicines are currently used in Australia to cure hep C. Direct-acting antivirals (or DAAs) are very effective for most people who take them.
How much do the medicines cost?
The new medicines to cure hep C are available through the Pharmaceutical Benefits Scheme (PBS) to people over the age of 18 who hold an Australian Medicare card. They cost no more than $41 for each script, or less than $7 if people have a concession card.
In terms of side effects?
The new DAA medicines have far fewer side effects than the older medicines. Side-effects may include:
Previously only 1% to 2% of people living with hepatitis C were seeking treatment. This number is increasing. Here are the numbers of people getting treated:
People are required by law to disclose they have hep C ONLY in the following circumstances:
These deaths are preventable now there is a cure available for hep C and treatment available for hep B.
Discrimination, or fear of discrimination, is a very real thing. Stories from people with hepatitis back this up.
People living with viral hepatitis often experience discrimination as a result of the stigma related to a presumed mode of transmission, such as intravenous drug use.
Stigma is one of the main reasons people avoid monitoring and treatment. Stigma can make people feel ashamed and isolated and damage their self-esteem. This can result in people avoiding getting tested, receiving treatment and support, and can help the virus to spread, driving it underground.
Discrimination on the grounds of viral hepatitis is illegal under Australian law: the Discrimination Act 1992 (Federal) and the Anti-Discrimination Act 1998 (Tasmania).
A peak community organisation to progress national action on issues of importance to people affected by hepatitis B and hepatitis C.
Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)
An online resource for primary healthcare professionals that supports the prevention, testing, diagnosis, management and treatment of STIs.
Statewide, peer-based consumer organisation, which strives to improve the health and social circumstances of substance users.
Hepatitis South Australia
A non-profit, community-based organisation that provides information, education and support services to South Australians affected by hepatitis B and hepatitis C.
C Me, Hear Me. Hepatitis C in our own words
Personal stories aimed to increase awareness and understanding of hepatitis C, dealing with symptoms, considering and managing treatment, and stigma and discrimination.
Help for Tasmanians affected by or at risk of BBVs (bloodborne viruses) and STIs (sexually transmissible infections).
National Hepatitis Hotline
1800 437 222
The Tasmanian Needle and Syringe Program (NSP) is a public health initiative to minimise the spread of bloodborne viruses, HIV/AIDS and hepatitis B and C among injecting drug users and to the wider community.
The NSP operates through different service providers. These include:
Primary NSPs provide a wide range of injecting equipment to injecting drug users, and they also:
There are 7 primary NSPs in Tasmania:
Secondary NSPs are programs operating in existing organisations, such as community health centres, regional hospitals and community houses. They:
There are 17 secondary NSPs in Tasmania:
Vending machines provide fit packs containing 1, 3 and 5ml syringes for a fee.
There are 4 vending machines in Tasmania:
HPP provides information, education and support to Tasmanians at risk of or living with hepatitis B and C.
The HPP is delivered for free, statewide for anyone over the age of 18 years.
The program aims to:
The HPP provides services to reduce viral hepatitis in Tasmania. Our service includes both emotional and practical support:
The Hepatitis Care and Support Service is available to clients primarily referred by Hepatology Clinics statewide. You can also ask your local GP for a referral or contact us directly at firstname.lastname@example.org and a worker can support you through the process.
To find out more, please call us on 1800 243 232
Look for risk factors for hep C:
Are you ready to take the Hepatitis Prevention Program quiz? Put your memory to the test and see if you can pass!
Please tick all answers that apply. Once you've successfully completed the quiz we will send you a certificate of attainment.
If you would like to provide direct feedback about this training session, we encourage you to complete our online survey here!