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Improving Hepatitis B Management in an Urban ACCHO

Improving Hepatitis B Management in an Urban ACCHO

Aboriginal and Torres Strait Islander people are a priority population for hepatitis B (HBV) prevention, testing and treatment with current estimates of the prevalence of active infection between 2-4% in urban settings. The Victorian Aboriginal Health Service (VAHS) has provided universal childhood vaccination from the early 1990s. The aim of this project was to evaluate HBV-related clinical practice within VAHS through examination of clinical data including testing, immune status and follow up of chronic infection, and to implement evidence-based practice as per current guidelines.

This project was part of the REACCH collaboration. HBV testing data of all patients attending VAHS from 2009-2012 aged 15-54 were extracted from the clinical database (Communicare) using GRHANITE® software. All serological markers relating to HBV immunity and infection were examined. A chart audit was undertaken to further examine immune and infection status, and management of chronic HBV infection. Changes were implemented to improve testing protocols, target immunisation of those at high risk of HBV infection, and better manage those with chronic HBV infection.

Of the total 5427 individuals who attended the medical service within VAHS in this period, 815 (15%) were tested for HBV. Of those tested, testing in accordance with current guidelines, increased from 6.4% to 71.8% in the study period. The findings of the chart audit (n=279) were; 53% Immune Vaccinated, 22% Resolved infection, 20% Non-immune, 3% Chronic infection. The changes implemented were (i) a routine testing protocol (HBVsAb and HBVcAb +/- HBVsAg), (ii) addition of HBV immune/infection status as a Clinical Item in Communicare and (iii) development of a Communicare template and recall system to support management of chronic HBV infection.

Clinical audit and implementation of protocols consistent with current guidelines has improved HBV-related practice at VAHS.


AIDS 2014

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