HBV Testing Policy v1.1 -> v1.2

The Expert Reference Committee met via teleconference from October 2015 to March 2016 to review the National Hepatitis B Testing Policy 2012 v1.1. Each section of the Testing Policy was systematically reviewed during these conversations. The recommended changes were incorporated in the revised National Hepatitis B Testing Policy v1.2

Most of the amendments made were minor wording changes to aid clarification, revisions to include reference to The 2^nd National Hepatitis B Strategy 2014-2017 and The Fourth National Aboriginal and Torres Strait Islander Blood Borne Virus & Sexually Transmissible Infections Strategy 2014-2017, and updates to statistical information. Other more significant changes made included:

Section 1.4.2 Mandatory or compulsory testing

• Testing for HBV is no longer a mandatory condition for performing exposure prone procedures

Section 2.1 Types of hepatitis B diagnostic tests

• Noted that hepatitis B genotype / mutation conferring resistance is not Medicare rebatable and a fee may be payable
• Recommending that, when determining protective immunity or its absence in at-risk groups, if anti-HBs is negative should also test for HBsAg and anti-HBc to exclude undiagnosed infection or distant past infection
• Recommending that, when testing in antenatal women, if possible also perform anti-HBs, to assess the need for vaccination
• Section amended to state that there are no HBsAg point-of-care (PoC) tests currently approved by the Therapeutic Goods Administration (TGA) for inclusion on the ARTG. If people in the community indicate they have received a positive or negative PoC test  from overseas the result should be confirmed by standard HBV testing in a NATA certified diagnostic laboratory

Section 3.0 Indications for HBV testing

• Children of women who are HBsAg positive added to the list of contexts where clinical suspicion of HBV infection may occur

Section 3.1.3 All patients undergoing chemotherapy or immunosuppressive therapy

• Amended to include more detail on the types of situations, risks and intentions behind testing and treatment in this patient group

Section 4.0 Informed consent for testing

• Clarification added that informed consent must be obtained for HBV testing

Section 5.6.5 Post mortem testing

• This section has been removed

Section 8.1 Routine testing (antenatal and perinatal testing)

• Section amended to state that an experienced clinician should assess any woman diagnosed with hepatitis B infection in pregnancy  rather than stating should be referred to a gastroenterologist, hepatologist or Infectious Diseases Unit

Updated version:  2015 National HBV Testing Policy v1.2

Previous version:  2012 National HBV Testing Policy v1.1