The multidisciplinary team

Shared care is the preferred model of support for people with viral hepatitis and chronic liver disease. The ability to coordinate support between primary care providers, specialists and specific referral centres will ultimately improve outcomes for people affected and reduce the duplication of services.

The utilisation of a shared care approach can:

  • improve access to care by decentralising care out of the tertiary setting
  • increase numbers of people on treatment
  • enhance access to care in rural and remote settings
  • promote coordination between agencies leading to increased referrals, and
  • identify systemic problems in the delivery of care and seek to solve the issue

Here, we consider the role of various specialities in the management of people living with viral hepatitis, specifically hepatitis C and B virus (HCV and HBV).

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Addiction and harm reduction

Injection drug use results in rapid dissemination of HCV,1 as well as some transmission of HBV.2 Therefore, attempts to eliminate HCV and HBV require an existing framework of harm reduction interventions.

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Hepatology

Hepatologists are at the forefront of healthcare when it comes to prevention and treatment of chronic and progressive liver diseases, including: HCV and HBV.

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Primary care

Given the prevalence of chronic liver disease in the community,3,4 it is essential that primary care providers play an active role in the screening, diagnosis and management of HCV and HBV.

References

  1. Van Handel MM, et al. County-level vulnerability assessment for rapid dissemination of HIV or HCV infections among persons who inject drugs, United States. J Acquir Immune Defic Syndr. 2016;73:323–31.
  2. Harris AM, et al. Increases in acute hepatitis B virus infections – Kentucky, Tennessee, and West Virginia, 2006–2013. MMWR Morb Mortal Wkly Rep. 2016;65:47–50.
  3. World Health Organization (WHO). Global Health Sector Strategy of Viral Hepatitis 2016-2021: Towards ending viral hepatitis. June 2016. Available at: https://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/ (accessed March 2019).
  4. Browning JD, et al. Prevalence of hepatitis steatosis in an urban population in the United States: impact of ethnicity. Hepatology 2004;40:1387-1395

Looking for in-depth information on liver diseases?

HCV

Hepatitis C

Background on the global and local burden of HCV; the expanding role of primary care in HCV management; diagnosis and pre-treatment assessment; HCV treatment and ongoing care. The important role of hepatitis nurses in the HCV care pathway is also discussed.

HBV

Hepatitis B

A comprehensive summary of currently available knowledge on HBV is provided here – information that reiterates the key role of primary care clinicians in screening, diagnosis and management of people living with HBV.

IHQ-LVD-2020-07-0020 DATE OF PREPARATION: JULY 2020