Hepatitis C remote consultation or specialist appointment referral
Since March 2016 the general listing of hepatitis C treatments was allowed on the Pharmaceutical Benefits Scheme.
General practitioners (GPs) experienced in the treatment of hepatitis C are encouraged to prescribe the relevant treatment or if preferred GPs can seek approval by a gastroenterologist, hepatologist or infectious diseases specialist before prescribing.
The Remote Consultation Initiation of Hepatitis C Treatment enables GPs to prescribe hepatitis C treatment following approval by a Fiona Stanley Hospital specialist (gastroenterologist/hepatologist). Read about our gastroenterology service.
Request remote consultation
GPs can request this service by completing the work-up (external PDF 553KB) posting or faxing a Hepatitis C remote consultation request form (PDF 276KB) or (Word 753KB) to the Central Referral Service (external site).
- Fax: 1300 365 056
- Postal address: GPO Box 2566, St Georges Terrace, WA 6831
The work-up includes information regarding the patient's hepatitis C genotype and viral load and a serum marker of liver fibrosis either APRI or Hepascore, which is all available from PathWest.
If the work-up results indicate more complex hepatitis C, the patient will be accepted to the waitlist for an appointment with a specialist.
Read more information about this community-based management option (external site).
If yu are unable to prescribe this treatment independently or in conjunction with FSH, please consider alternative referral pathways such as referral to a:
- participating GP
- private specialist.
Refer for specialist appointment
If the work-up results indicate more complex hepatitis C, as per the criteria below, the patient should be referred for specialist assessment via CRS, using the statewide general adult referral form for specialist outpatient appointment.
Referral criteria for specialist assessment
For Hepatitis C with:
- Cirrhosis as evidenced by
- APRI > 1.0 OR
- Hepascore > 0.8 OR
- Fibroscan > 12.5 kPa.
- Co-infection
- Other hepatitis
- HIV with advance liver disease (Note: in the absence of advanced liver disease, HIV-HCV co-infection should be referred to Infectious Diseases).
- Significant co-morbidity
- Complex medication interactions* (see HEP Drug Interactions tool http://www.hep-druginteractions.org/)
- Significant cardiopulmonary disease or significant renal impairment (eGFR <30).
- Prior antiviral treatment failure.
For non-complex hepatitis C for specialist appointment ONLY where GP provides evidence of barriers to community-based treatment.
Barriers to community-based treatment include:
- geographical/transport
- financial
- other – please describe
Referral instructions
Refer via CRS using the statewide general adult referral form (external site) for specialist outpatient appointment.
Referrers must attach a work-up and a copy of laboratory results including:
- date of diagnosis
- inter-current conditions
- current medications (prescription, herbal, OTC, recreational)
- Liver Fibrosis Assessment:
- Hepascore or APRI or Fibroscan
- laboratory results:
- HCV genotype
- ALT
- bilirubin
- creatinine
- haemoglobin
- HCV RNA level
- AST
- albumin
- eGFR
- platelet count
- INR.
* If referring because of complex medication interactions please specify the detail, if possible attach results of HEP Drug Interactions tool (external site).