What's new? | HCV

What’s new in the Hepatitis C Testing Policy 2020?

The Expert Reference Committee (ERC) met via teleconference from November 2019 to June 2020 to review the National Hepatitis C Testing Policy 2017. Each section of the Testing Policy was systematically reviewed during these meetings and via subsequent email exchanges. Smaller working groups were established and focused on updating specific chapters which were then reviewed again by the entire ERC. The recommended changes were incorporated in the revised Hepatitis C Testing Policy v1.3.

Some of the amendments made were minor wording changes to aid clarification, revisions to include reference to Fifth National Hepatitis C Strategy 2018- 2022, and updates to statistical information and references. Other more significant changes are listed below.

Section: Executive Summary

An Executive Summary was added to highlight the key points and changes included in the policy.The Executive Summary also incorporates the World Health Organization’s five principles of testing: consent, confidentiality, counselling, correct test results, and connection/linkage to prevention, care and treatment.

Section 1: Introduction

This section was updated to include the latest available epidemiology statistics and references.

Section 2: Diagnostic Strategies

This section was updated to include additional wording on the seroconversion window and clarification regarding the window period and funding for HCV RNA if in very early phase of HCV. Supplementary wording on HCV RNA reflex testing and recent PBS change regarding the removal of mandatory requirement for genotype prior to treatment initiation were added.

The Testing Pathway was simplified and wording in boxes was updated to provide greater clarity.

Section 3: Indications for HCV testing: 

This section has been expanded to include ‘Populations to consider for an HCV Test’ to align with the Australian recommendations for the management of hepatitis C virus infection: a consensus statement (June 2020).

Section 3.2.6, Aboriginal and Torres Strait Islander populations, highlighted the gap in identification of Indigenous status in notifications and the need for greater focus by medical staff on the Aboriginal and Torres Strait Islander identifier.

Section 3.3, Occupational exposure, provides guidance on when and how to test workers if a potential occupational exposure has occurred.

Section 4: Informed consent

This section was updated to provide clarity around the requirements for informed consent for HCV testing, highlighting that additional support and interpreter services to aid a person’s understanding may be needed. A reference and link to a new resource, Fact sheet for clinicians: Informed consent in health care, was also added.

Section 5: Conveying HCV test results

This section was updated to improve clarity for providing results at various stages of testing. Additional advice for health professionals was included to misspell the myths regarding the costs of treatment with DAAs but highlight the benefits.

Section 6: Surveillance and research

This section was updated to provide greater clarity regarding the annual Australian Needle and Syringe Program Survey.

Section 7: Healthcare workers

This section was rewritten to align with the updated Australian National Guidelines for the management of healthcare workers living with blood borne viruses and healthcare workers who perform exposure prone procedures at risk of exposure to blood borne viruses

Section 8: Antenatal and perinatal testing

This section was expanded to include the benefits of routine screening for HCV infection for women contemplating pregnancy or presenting for antenatal care. A new recommendation for HCV RNA testing in babies born to HCV- positive mothers from as early as 8 weeks has been included.

Section 9: Quality assurance of HCV testing

This section was updated with requirements for laboratories that perform testing, TGA evaluation and quality assurance of pre-and post- In-Vitro Diagnostic Devices.

Section 10: Point-of-care and self-tests for HCV

The title, content and references in this section were updated to include the addition of a Point-of-care test for the detection and quantification of HCV RNA approved by the TGA in June 2020 and changes to the supply of self-tests under the Therapeutic Goods (Medical Devices—Excluded Purposes) Specification 2020 from 1 October 2020.

Section 11: Funding of HCV testing

This section was updated to direct inquiries concerning matters of interpretation of MBS items, including eligibility, via email to: [email protected].