Newsletter Issue 21 | April 2018
BACK TO BASICS...ABC What is viral hepatitis? | P.7
MY JOURNEY TO THE CURE Samy’s Story | P.14
Hep C Cure! Turn to P.22
for more info.
Newsletter Editor Eliana Ennis Graphic Artist Eliana Ennis Board of Management Executive Members Chairperson Ms Ursula Swan Vice Chairperson Ms Max Taylor Treasurer Mr David Wilding Secretary Ms Selena West Non Executive Members Dr Aesen Thambiran Ms Carol Houghton Patron Dr Charles Watson Executive Director Frank Farmer Postal Address PO Box 67 Francis Street Northbridge, WA 6865 Information & Support Line Monday - Friday 9am - 5pm (08) 9328 8538 Metro 1800 800 070 Country
COVER PHOTO
CREDIT
Office 134 Aberdeen Street Northbridge, WA 6003 Telephone: (08) 9227 9802 Fax: (08) 9227 6545 Web: www.hepatitiswa.com.au Proof Reading Frank Farmer Sally Rowell Email the Editor resources@hepatitiswa.com.au
PHOTO BY THIEN DANG unsplash.com/@thiendanga9 HepatitisWA (Inc). HepatitisWA is a community based organisation which provides a range of services to the community in response to viral hepatitis, particularly hepatitis B and C. Please contact us for more information, or make an appointment to stop by and talk with an appropriate member of our staff.
Opinions published in the HepatitisWA Newsletter are not necessarily those of the editor or of HepatitisWA (Inc). Information in this newsletter is not intended to take the place of medical advice from your GP or specialist. You should always get appropriate medical advice on your particular needs or circumstances. *Disclaimer: The copyright of external articles published in this newsletter remain with the original authors and publishers, unless otherwise stated.
APRIL 2018
CONTENTS
10
14
PERSONAL PERSPECTIVE
COMMUNITY NEWS
PROMOTIONS
14 My Journey to the Cure
04 Letter from the Editor
05 Join us in the Social Media World
An interview with Samy and his experience being cured of hep C
FEATURES 06 Common Questions: Separating Fact from Fiction
How much do you know about hepatitis B and C?
07 Back to Basics...ABC Learn more about the difference
between hepatitis A, B and C.
10 Hepatitis C & People who Inject Drugs: What’s Happening in Australia?
Written by Eliana Ennis
08 Going Viral A round-up of articles on viral hepatitis.
22 Where do I go to get hep C testing and treatments?
HEALTH & LIFESTYLE
Connect with HepatitisWA on Facebook and Twitter today.
14 Deen Clinic Services 24 Hepatitis C Cure
PEER BASED HARM REDUCTION WA’S DOMAIN 20 Exciting changes occurring
16 Self-care Tips to help you prevent illness
Read more about WASUA’s change in name and brand
and injury in everyday life.
18 Recipe: Mexican Tortilla Melt Recipe by Live Lighter
12 Welcome to the Deen Clinic
Interview with Rebecca, Nurse Coordinator at the Deen Clinic
stay
connected www.hepatitiswa.com.au
www.facebook.com/HepWA
www.playthebloodrule.com
www.twitter.com/HepatitisWA
HepatitisWA Newsletter // April 2018
3
LETTER FROM THE EDITOR Welcome to the first edition of the HepatitisWA newsletter for 2018! Our focus this year is to continue the work we started in 2017 by spreading the word about the hepatitis C cure! After completing a Facebook campaign in January 2018 called ‘my promise to myself this year is to get rid of hep C’ we realised there is some confusion about what hepatitis C is and what treatments are available. Therefore, we decided to create a quick overview called ‘Back to Basics…ABC’ which highlights the main differences between hepatitis A, B and C. (page. 7) It was also noted that many people who responded to the campaign did not understand that the new hep C treatments are very different to interferon. They have a 95% cure rate and minimal side effects. Our personal perspective in this edition follows Samy’s challenging journey through the old treatment, interferon (page. 15). His story is a reminder of how far we have come since the new treatments have been released. Our feature ‘Hepatitis C and People who inject Drugs: What’s happening around Australia’ (page. 10) gives a great summary of how Western Australia is progressing with uptake and accessibility to treatment compared to other states. To help readers learn more about accessing testing and treatment we have included a list of doctors and pharmacies that prescribe the new hepatitis C medicines. (page. 22) Please note: the list of GPs and pharmacies is by no means an exhaustive list. We do recommend that people ask their own GP if they are treating hep C before pursuing another practice. One of the clinics on the list is HepatitisWA’s Deen Clinic. At the end of last year, the Deen Clinic welcomed a new Nurse Coordinator, Rebecca. We have included an interview with her to learn more about her experience working in the clinic. (page. 12) We also hope you enjoy our health and lifestyle ‘self-care’ feature (page. 16) giving us tools on how to better take care of ourselves. Not to mention, a delicious and easy ‘Mexican Tortilla Melt’ recipe. Stay tuned for the release of our July edition as we celebrate World Hepatitis Day!
Eliana Ennis Editor 4
HepatitisWA Newsletter // April 2018
j o i n u s i n t h e s o c i a l m e d i a w o r l d. . . . Keep up-to-date on: Latest news Events Resources & Publications Campaigns while connecting with our community
F i n d u s o n w w w. fa c e b o o k . c o m : H e pat i t i s WA
F i n d u s o n w w w.t w i t t e r .c o m : @ H e pat i t i s WA
common Questions. separating fact from fiction HEP B
True or false? You can tell if someone has hepatitis B by looking at them.
HEP C
Can you get hep C from reusing your own needle?
&
False! For most people, hepatitis B does not have any obvious symptoms but the virus can still be causing liver damage.
can hepatitis B cause liver cancer?
Yes, up to 30% of people with Hepatitis B can develop Liver Cancer.
Do I only need one vaccine injection to be immune to hepatitis B? People need to have 3 hepatitis B vaccine injections over 6 months to be fully immune to hepatitis B.
Is hepatitis B in food or shellfish?
No. hep B can only be transmitted through; Mother to baby during birth, sexual fluids (male & female) and blood to blood contact.
No! A person is only at risk of being infected with hepatitis C if they share the same needle or syringe of a person living with the virus.
True or false? Hepatitis C CANNOT be caught from sharing: hugs, kisses, food, cups, gym equipment, office space, public transport True, hep C can only be transmitted through blood to blood contact.
Does alcohol cause hepatitis C?
No, but if you have hepatitis B or C, drinking alcohol can accelerate liver damage.
true or false. There is a Cure for hep C.
True, there is now a cure for hep C. Treatment includes one tablet a day for 8-12 weeks with a 95% cure rate!
Can you get hepatitis B from Mosquitos?
No, hepatitis B is not transmitted by mosquitos.
do you have another question about hep B or hep C? Contact our helpline on 9328 8538 or visit
6
HepatitisWA Newsletter // April 2018
hepatitiswa.com.au
BACK TO BASICS...ABC... VIRAL HEPATITIS IS INFLAMMATION OF THE LIVER CAUSED BY A VIRUS.
THERE ARE FIVE DIFFERENT HEPATITIS VIRUSES, HEPATITIS A, B, C, D AND E. THE MOST COMMON THREE ARE HEPATITIS A, HEPATITIS B AND HEPATITIS C. READ BELOW TO SEE HOW THE VIRUSES ARE TRANSMITTED, PREVENTED AND TREATED.
A
B
HEPATITIS
HEPATITIS
TRANSMISSION:
TRANSMISSION:
TRANSMISSION:
Hepatitis A is spread mainly through
Hepatitis B is transmitted through
Hepatitis C is spread through
eating food or drinking water that has
contact with the blood or other body
blood-to-blood contact.
been contaminated by the faeces of a
fluids (i.e. semen and vaginal fluid) of a
person living with the virus.
person living with the virus.
PREVENTION:
It can also be spread by eating raw
It can be passed on from mother to child
shellfish that has come from water
during childbirth. (If the mother has
contaminated by sewage.
hepatitis B)
PREVENTION:
PREVENTION:
There is a vaccination for hepatitis
There is a vaccination that can
living with hepatitis C. It is also wise to
A. Treatment within a few weeks of
prevent infection. If you have not
avoid getting tattoos or body piercings
exposure to the virus can also bring
been vaccinated, to reduce chances of
from unlicensed facilities.
short term immunity. You can reduce
exposure it is best to use condoms, and
the risk of exposure by practicing good
to avoid sharing needles or items such as
hygiene and sanitation, and avoiding
toothbrushes, razors or nail scissors with
drinking water that has come from a
a person living with hep B. It is also wise
potentially unsafe source.
to avoid getting tattoos or body piercings
TREATMENT:
from unlicensed facilities.
As hepatitis A only causes acute
TREATMENT:
hepatitis, the body is often able to clear
A variety of antiviral drugs are available
the infection itself within a few weeks.
which slow the replication of the virus
However, hepatitis A infections can
and occasionally result in its clearance.
sometimes cause further complications.
Children born to mothers infected with
C
HEPATITIS
There is no vaccination for hepatitis C. It is therefore necessary to reduce risk of exposure, by avoiding sharing needles and other items such as toothbrushes, razors or nail scissors with a person
TREATMENT: Treatment for chronic hepatitis C aims to eradicate the virus. There is an increasing use of direct acting antiviral drugs, which have a 95% cure rate. So there has never been a better time for people to access these treatments.
hepatitis B should also be vaccinated within 12 hours of birth, as this can prevent an infection that will most likely progress to chronic hepatitis B.
WANT TO LEARN MORE? VISIT OUR WEBSITE: WWW.HEPATITISWA.COM.AU AND CLICK ‘ABOUT HEPATITIS’ OR CALL OUR HELPLINE 9328 8538. HepatitisWA Newsletter // April 2018
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GOING VIRAL A R O U N D - U P O F A R T I C L E S O N V I R A L H E PAT I T I S
VIRAL HEPATITIS: NOT JUST A SILENT KILLER BUT ALSO A SILENCER
S
tigma and discrimination around viral hepatitis has long prevented people from speaking openly about their illnesses. For those brave enough to disclose their status, their reward, more often than not, may be social exclusion, diminished employment opportunities or unjust barriers to receiving healthcare. This harsh reality can have a devastating impact on an individual’s personal life and psychological well-being and prevent people from accessing much-needed diagnostics and treatment. There is no doubt that stigma and discrimination further perpetuate the epidemic of viral hepatitis. The Holding Governments Accountable: World Hepatitis Alliance Civil Society Survey Global Findings Report, surveyed civil society organisations from 72 countries to better understand experiences of stigma and discrimination across the world. The findings confirmed and quantified what we had long suspected: stigma is felt in almost every corner of the globe (people from 93% of countries surveyed reported stigma and discrimination to some degree) and its impact is far-reaching (respondents reported on average 8
6 different types of stigma and discrimination). Certain forms of stigma were shown to be especially common: almost 3 in 4 respondents report issues with internalised stigma; over half of respondents report having been socially excluded due to their illness; and 42% have experienced stigma and discrimination in the workplace. “The person who discriminated against me first was myself ” reveals George Kalamitsis, Chairman of Hellenic Liver Patient Association, Greece. Self-stigmatisation can include feelings of blame, worthlessness, internalised shame or a sense that viral hepatitis is a punishment for certain behaviours. It is truly heart-breaking to learn that 72% of people living with the virus experience these feelings. Selfstigma has both emotional and long-term physical consequences, often preventing people from speaking out and breaking down the confidence needed to seek help and access medical care. In fact, this can be one of the biggest barriers to diagnosis. Misconce ptions around transmission routes, prejudice towards the social groups or lifestyles associated with the disease, or fear of discrimination once a diagnosis is confirmed all prevent people from getting tested. Tackling stigma and discrimination will be fundamental to finding the 300 million people living with viral
hepatitis unaware, linking them to care and ultimately eliminating viral hepatitis. WORLD HEPATITIS ALLIANCE March 2018 This is an excerpt from a blog by World Hepatitis Alliance CEO Raquel Peck that first appeared in Hepatology, Medicine and Policy. read the full article at https://blogs.biomedcentral.com/onhealth/2018/03/01/viral-hepatitis-not-just-a-silentkiller-but-also-a-silencer/
SMOKING REDUCES SURVIVAL AFTER LIVER CANCER DIAGNOSIS FOR PEOPLE WITH VIRAL HEPATITIS
P
eople with viral hepatitis who smoked were three times more likely to die after being diagnosed with liver cancer (hepatocellular carcinoma, HCC), according to a study of Swiss patients published in Liver International. Whereas non-smokers lived for a median of 3.2 years after diagnosis, smokers died after a median of 18 months. Smoking had a similar impact on survival in those who did not receive curative treatment in the form of liver resection (surgery), liver transplantation or ablation (use of heat to destroy tumours in the liver). Smoking has been found to increase the risk of developing liver cancer in some, but not all studies, and to increase the risk of liver cancer in some studies of
HepatitisWA Newsletter // April 2018
Disclaimer: The news articles displayed in the HepatitisWA Newsletter remain the copyright of the original authors and news publications.
COMMUNITY NEWS
people with viral hepatitis. To look at the effect of continuing to smoke after a diagnosis of primary liver cancer (HCC) Swiss researchers analysed survival in 238 people with at least 12 months of follow-up after diagnosis of HCC. Sixty-four reported smoking at the time of inclusion in the cohort study. Smokers were followed for a median of 489 days and non-smokers for 1170 (p = 0.002), the difference reflecting the poorer survival in smokers. HCC developed at a younger age in smokers (59 vs 66 years, p < 0.001). There was no significant difference between smokers and nonsmokers in the stage of liver cancer whether measured by Child-Pugh grade or BCLC (Barcelona Clinic Liver Cancer) system, nor in any markers of liver damage with the exception of platelet counts and INR (international normalised ratio) scores. Smokers showed some evidence of greater liver injury. They had lower platelet counts and slightly higher INR scores. (Smokers usually have higher platelet counts than nonsmokers.) There was no difference between smokers and non-smokers in the type of treatment they received. HCC attributable to viral hepatitis (B or C) or alcohol was more common in smokers. A multivariate analysis which controlled for other risk factors
showed that smoking increased the risk of death in people with viral hepatitis diagnosed with HCC (HR 2.41, 95% CI 1.28-4.41, p = 0.007) but not in people with liver cancer attributable to other causes. A more advanced stage of HCC at diagnosis also increased the risk of death (HR 2.73, 95% CI 1.93-3.85, p < 0.001). Smoking is known to increase liver fibrosis in people with hepatitis C and might also directly influence HCC progression after diagnosis. Poorer fitness or less compliance with medical treatment or advice might also affect survival, the investigators suggest. They say that it is not possible to tell from their cohort whether the effect of smoking was a consequence of smoking intensity – how many cigarettes a day – or duration (persistence in smoking after diagnosis). “Based on these findings, smoking cessation should be considered for incorporation into the disease management for patients with HBV or HCV [with HCC],” the authors conclude. They point out that around 80% of HCC cases worldwide are probably attributable to viral hepatitis. Reference: Kolly P et al. Effect of smoking on survival of patients with hepatocellular carcinoma. Liver International 37: 1682-1687, 2017.
AIDSMAP . Keith Alcorn | www.aidsmap.com January 18, 2018
16TH-CENTURY CHILD MUMMY HAD OLDEST KNOWN CASE OF HEPATITIS B
In 2016, researchers examining a case of ancient small pox, found in a sixteenth-century Lithuanian mummy, decided to re-examine the Maggiore mummy with the hopes of studying how the disease evolved over time. They sequenced the mummy’s DNA and examined it but found no trace of the smallpox virus. Instead, they discovered a fragment of hepatitis B. Further study of the mummy helped researchers realize that the rash or dots on the child’s face could have been caused by Gianotti-Crosti syndrome, one of the potential symptoms of hepatitis B (HBV). SMITHSONIAN.COM January 2018 To read the full article visit Smithsonian.com https://www.smithsonianmag.com/smart-news/childsmummy-rewrites-history-hepatitis-b-180967776/
Do you want to learn more about viral hepatitis, testing and treatments? Visit our website hepatitiswa.com.au or call our helpline on (08) 9328 8538.
HepatitisWA Newsletter // April 2018
9
Hepatitis C & people who inject drugs:
what’s happening around Australia? Reprinted from vol. 15, ed. 1 of Anex Bulletin, published by Penington Institute. by John Ronan. Hepatitis C is a disease that has had serious impacts in Australia. An estimated 800 people die from complications of the disease each year. It remains the number one reason for liver transplantation. But in Australia we are now making strong inroads into tackling hepatitis C. Ground-breaking new direct-acting antivirals (DAA) treatments mean that the disease, if treated properly, can be cured with fewer side effects than previous treatments. Of those people who have been treated with these drugs so far around 95 per cent have been cured. This is extremely positive news for Australians living with hepatitis C. But of course just because new treatments exist it doesn’t mean the disease is no longer having an impact. In 2015, an estimated 227,310 people were living with chronic hepatitis C infection in Australia, among whom 19 per cent commenced DAA treatment 10
between March 2016 and June 2017. It is estimated that there are now approximately 190,000 to 200,000 people living with chronic hepatitis C in Australia. This takes into consideration new infections. The Australian Government has set an ambitious target to eliminate hepatitis C in Australia by 2030 and we must remember that people who inject drugs are a vital piece of the hepatitis C puzzle. The prevalence of people in this group who attend NSPs (Needle and Syringe Programs) and have hepatitis C is 55-70 per cent and the majority of new infections in Australia are coming from people who share injecting equipment. NSPs reach more people who inject drugs than any other service, so there is an important opportunity to capitalise on this connection. Around Australia there are a range of programs in place that are making a difference for people who inject drugs.
Western Australia • Estimated number of people living with hepatitis C in 2015: 20,549 • Uptake of DAA treatment in (March 2016 to June 2017): 3,320 (16 per cent) In Western Australia, HepatitisWA and the WA Substance Users Association provide hepatitis C treatment clinics, with target groups including people who are currently injecting drugs. A lot of work is underway to promote testing and treatment including the clever use of videos on social media to encourage more Aboriginal people to get tested and treated. Pre-packaged needle kits
HepatitisWA Newsletter // April 2018
Source: Article by John Ronan. Reprinted from vol. 15, ed. 1 of Anex Bulletin, published by Penington Institute
FEATURE such as Fitpacks and Fitsticks, which are distributed through NSPs and sold in pharmacies, feature labels with useful information such as the importance of testing and the new treatments that are available.
The focus can’t just be on curing those who have been infected by hepatitis C, it is vital to work to help stop it spreading in the first place by reducing or preventing the sharing of injecting equipment. One of the challenges Western Australia faces is developing more NSP sites, particularly in regional and rural areas where they are few and far between. Much more also needs to be done to develop and implement strategies to increase access to NSPs for Aboriginal and Torres Strait Islander people who inject drugs as well as access to sterile injecting equipment in prisons.
Northern Territory • Estimated number of people living with hepatitis C in 2015: 3,606 • Uptake of DAA treatment (March 2016 to June 2017): 430 (12 per cent) The task in the Northern Territory is a difficult one given that the territory has such a small population size spread over a large area. Client and staff movement and staff turnover can make it difficult to engage clients about safe injecting practices, testing, treatment and follow up. The territory has three primary NSP outlets, which handle around 80 per cent of occasions of service. The Northern Territory AIDS and Hepatitis Council (NTAHC) raises awareness about the availability of direct-acting antivirals with clients and works with
people living with hepatitis C through its care and support program and sex worker outreach programs. A lot of work in the territory involves spreading the message of blood-borne viruses, including hepatitis C, and the importance of getting tested. Specialist sexual health service Clinic 34 promotes testing for clients who inject and remote sexual health teams do the same. The Sexual Health and Blood Born Virus Unit and NTAHC deliver education as well as needle and syringe program orientation in primary care settings as well as the broader community. Awareness of hepatitis C is also promoted through events such as World Hepatitis Day and International Overdose Awareness Day.
Victoria • Estimated number of people living with hepatitis C in 2015: 55,261 • Uptake of DAA treatment (March 2016 to June 2017): 10,770 (19 per cent) The Victorian Hepatitis C Strategy 2016–2020 sets targets to increase prevention, testing and treatment of hepatitis C, and to reduce stigma and discrimination. The Victorian Hepatitis C Elimination Working Group has been established to ensure as many Victorians as possible are screened, tested and able to access the new treatments, as quickly as possible. The Government has also partnered with the Primary Health Network Alliance to build specific and local hepatitis C clinical health pathways. The Victorian HIV and Hepatitis Integrated Training and Learning program delivers comprehensive education and training for GPs on the diagnosis, treatment and management of hepatitis B and C. Meanwhile, the Eliminate Hepatitis C Partnership, a collaboration of service providers, government departments and researchers in Victoria, is aiming to increase the uptake of treatment for hepatitis C virus infection among people who inject drugs. HepatitisWA Newsletter // April 2018
11
Welcome to the
a cc ReRDIbe et MeNUR NAT OR SE COO WHAT IS YOUR ROLE AT THE DEEN CLINIC? My role is Nurse Coordinator, which basically means I arrange the appointments and support people as they go through the hep C treatment.
WHAT IS IT LIKE WORKING AT THE DEEN CLINIC? This is a very happy job, Iâ&#x20AC;&#x2122;m seeing peopleâ&#x20AC;&#x2122;s lives change! No two days are the same, and I like it when my days are busy with appointments. Since hepatitis C is a confronting issue for a lot of people, it can cause anxiety. Therefore, if someone can build up enough confidence to come and talk about it I want to make sure I am in a position to respond to them as soon as possible. 12
HepatitisWA Newsletter // April 2018
Source: This is a Press Release issued by WHO, Geneva
This is a virus that some patients have had for a very long time and they may think it is incurable. Or if they have heard of treatments they only believe it to be curable through the old interferon treatments which sometimes resulted in side effects that were worse than the actual virus. So, to be able to see people get cured after only 3 months of treatment, by only taking one tablet a day, is amazing!
DO YOU HAVE A FAVOURITE PART OF YOUR JOB? I love talking to people and building relationships with each client during their three months of treatment. I also like being able to give people second chances. We have had clients come back to get treated again for hep C with concerns that
FEATURE they may have been reinfected. I like being able to tell them that it’s ok and there is no shame in that.
TO SOMEONE ABOUT TREATMENTS THAT THEY THINK YOU’RE STILL TALKING ABOUT INTERFERON?
WHAT IS THE MOST COMMON WAY PEOPLE HEAR ABOUT THE DEEN Yes, this is often one of the first things that needs CLINIC? to be addressed with the patient. A third of our clients come through the needle and syringe program. These people are already taking care of themselves while using, (accessing clean needles and injecting equipment). We have also had people contact us through our website, Facebook page and also receive a number of referrals from GPs.
WHY DO CLIENTS CHOOSE TO GET TREATED THROUGH THE DEEN CLINIC RATHER THAN WITH THEIR OWN GP? Sometimes patients are not comfortable to complete treatment with their own GP so our service provides an alternative option. Also, since we have a Gastroenterologist if the patient has cirrhosis it may be easier for them to get a specialist appointment, perhaps rather than a liver clinic.
DO YOU BELIEVE THERE TO BE ANY BARRIERS STOPPING PEOPLE FROM ACCESSING HEP C TESTING AND TREATMENTS? There is evidence stating that men are more prone to not seek medical assistance when it is needed. This would be a barrier for reaching men. For some women, they may find it difficult to commit to a 3-month treatment due to other commitments including caring for family so taking care of their own health is not always a priority. In general, I think the stigma probably carries a lot of weight. Often they do not want to tell their GP that they have hepatitis C. The perception of the old treatment is still lingering, so I don’t think some people realise there is a cure available.
DO YOU THINK WHEN YOU’RE TALKING
WHAT OTHER STRATEGIES COULD BE USED TO ENCOURAGE MORE PEOPLE TO SEEK TESTING AND TREATMENT? I think it would be very interesting to do some work development with some of the largest employers in WA including BHP and Rio Tinto. It’s a population group that is predominately male and from our research we know that 66% of our clientele are male so this would be a good way to target a large group. I believe HepatitisWA has built some great relationships with other organisations to promote the hep C treatments. At St Bartholomew’s House we have started a once a month outreach for people living there to access treatment and testing and also providing education around viral hepatitis to their staff. Partnerships with organisations including Street Doctor, Passengers Youth Centre, Women’s health centre in Northbridge also help to grow awareness.
WHAT WOULD YOU SAY TO SOMEONE CONSIDERING THE HEP C TREATMENTS? Just do it! It’s not a big deal. Better to get treated now rather than wait until there is serious damage to your liver. IF YOU HAVE HEPATITIS C AND WOULD LIKE TO GET TREATED THROUGH OUR DEEN CLINIC CONTACT OUR NURSE COORDINATOR REBECCA ON (08) 9227 9800 TO ARRANGE AN APPOINTMENT. HepatitisWA Newsletter // April 2018
13
My journey to the cure: Samy’s story When and where were you first diagnosed with hepatitis C? I’m originally from Egypt but in 2007 I was working in Dubai when I found out I had hepatitis C. At the age of 2 I had a blood transfusion in Egypt and that’s how I believe I was exposed to the virus.
Why did you get a test for hepatitis C? I went in for minor surgery in Dubai. Prior to the surgery, I had some routine blood tests and a hep C check was one of them. The test result was positive for hep C antibodies. If I hadn’t needed surgery, I wouldn’t have been tested and known I had the virus. It’s common to be checked for these viruses prior to surgery in Dubai. However, I was no longer concerned about the surgery but was very anxious about the virus.
How did you feel about the diagnosis and how did it affect you? It affected me dramatically, my life was flipped upside down. I was in my late 20s working hard and enjoying a bachelor lifestyle in Dubai. I suddenly started being anxious and wondering about my illness. A lot of questions were going on in my mind: What is hep c? Am I going to transfer it to someone else? Am I going to die? When the doctors told me, they just gave me the diagnosis. Their job was to take care of the minor surgery at that time. Their concern wasn’t that I had hep C so they didn’t give me information on how to get treated or what’s the next step. That didn’t help at all! I had to do research and educate myself about it and went to see a specialist.
C? If so, how did they respond? I only told my brother. I didn’t tell my Mum and sister because they were back in Egypt and I didn’t want them to worry. I didn’t tell friends around me either. The people I did tell were more concerned about how and where I’d got it! At the time I didn’t know the answer and I felt sad this was their only concern. I felt alone and decided not to share this with anyone else. It was also hard to know if I should tell someone who I was in a relationship with.
Why did you seek treatment and how did you find the experience? I sought treatment because I wanted to get rid of the virus. I was treated with combined interferon and ribavirin twice. The first treatment was in 2007 in Dubai. That didn’t go well. I was prescribed a weekly interferon injection and a daily dose of ribavirin for 48 weeks. After the third week, I started feeling very weak and my body ached a lot with any simple movement due to my low immune system and white blood cell count. I decided to stop treatment, however, I continued a healthy lifestyle and didn’t drink alcohol. In 2009, I moved to Western Australia for work and after 2 years of settling into the new country, I decided to try the treatment again. The experience was very different this time. I received more support from the doctors and nurses at the Royal Perth Hospital. Though I had the same issue with my immune system and the low white blood cell count, I decided to keep going through the 48 weeks of treatment. Every week on Thursdays I’d receive the interferon injection. Then on Tuesday I’d receive a neupogen injection to help boost my low immune system and white blood cell count. I also had a daily dose of ribavirin. This routine continued for 48 weeks. I had to change my work routine to part-time because of this schedule.
The positive part of the diagnosis was I started to live a healthy lifestyle. I stopped drinking alcohol and ate healthy food.
The treatment experience was a challenge. The side effects of the neupogen were even worse than interferon. I got very bad aches and pains and a very high fever every time I took the injection. I didn’t have an appetite to eat and lost a lot of weight. I also became a bit paranoid and halfway through the treatment got depression. I didn’t feel like myself. Doctors put me on anti-depressants for a few months leading up to the end of my treatment. Due to these bad side effects, I didn’t go out much and felt very isolated.
Did you tell your family and friends about the hep
How do you feel now that you’ve completed the
14
HepatitisWA Newsletter // April 2018
PERSONAL PERSPECTIVE
“ I’m Cured! I now feel physically and mentally stronger!”
treatment? I am cured so it was all worth it! I have more energy
In 2016, 5 years after Samy was
too which is great! Every year I get a check-up to make
cured, new treatments which are
sure that my liver is ok and I am still clear. So far so good!
How has your life changed since you’ve got rid of hep C? I learnt a lot from the experience, about health and how
direct-acting
antivirals
became
available in Australia. These new hep C treatments have over a 95%
the body functions. I now feel physically and mentally
cure rate and in majority of cases
stronger and I am very happy. This was the biggest
treatment only lasts for 8-12 weeks
challenge that happened in my life and I am thankful to have gone through it.
with minimal side-effects. If you are
I’m happy to share my hep C cure story with others.
living with hep C call HepatitisWA
I also have more empathy for people that are going through any chronic sickness or treatment. Going
helpline 9328 8538 to learn how you
through the treatment has made me feel others’ pain
can access these new treatments.
and want to support them in any way I can.
HepatitisWA Newsletter // April 2018
15
Self Care
getting active
W hat
is self - care ?
Self-care means taking steps to prevent illness and injury in everyday life through a healthy lifestyle and being aware of your actions.
healthy eating
Self-care is also being able to treat yourself, in the comfort of your own home, when you are suffering from minor illness or injury. Less time spent being sick means more time to spend with your family, friends and enjoying the things you love.
Daily choices and lifestyle It is each personâ&#x20AC;&#x2122;s responsibility, once they are an adult, to ensure they look after their health, and the health of their children.
Ways you can improve your health include: Eating healthy and nutritious foods Getting active Limiting your alcohol consumption Quitting smoking Looking after your mental health Maintaining good dental health.
Minor illness and injury
quit smoking
16
Many common, minor injuries and illness can be managed at home with bed-rest or over-the-counter medicine. Illnesses commonly treated with self-care include: common colds (including sore throats and coughs), hangover, headache, muscle ache, nose bleeds.
HepatitisWA Newsletter // April 2018 Source: Republished from WA Department of Health - for more information visit healthywa.wa.gov.au
HEALTH & LIFESTYLE
Injuries commonly treated with self-care include: grazes, scratches and cuts, bites and stings, sprains and strains (sporting injuries), bruises and bumps. NOTE: If an illness or injury is chronic or lasts for more than a few days, seek GP advice.
Managing minor illness and injury at home Home first aid kits First aid kits can be purchased for the home and are a good idea. These can be purchased from medical suppliers or from a number of retail stores.
limit alcohol consumption
However it is also easy to make up a kit yourself to treat most minor illnesses and injuries.
Your kit should include: band aids, tweezers, bandages, adhesive tape, disposable gloves, scissors, non-adhesive dressings, first aid booklet, paracetamol (age appropriate), antiseptic cream/wash. Additional items may also include: thermal blanket, resuscitation mask or face shield Your first aid kit should be stored in a clean, dry place away from children. Items should be replaced when used or expired. Minor injuries such as sprains and muscle aches can also be managed at home using a home first aid kit and the RICE method:
Rest Ice Compression (bandaid or bandage) Elevation HepatitisWA Newsletter // April 2018
17
HEALTH & LIFESTYLE
MEXIBEAN TORTILLA MELT Ingredients: 440 g can no-added-salt red kidney beans, drained and rinsed 1/2 red capsicum, seeded and finely chopped 1 tomato, diced 2 spring onions (including green tops), ends trimmed, chopped
1/2 cup fresh coriander, chopped 1/2 cup reduced-fat cheddar cheese, grated 1/2 tsp ground cumin or ground coriander 1/2 tsp smoked paprika 4 wholegrain or reduced-fat tortillas or soft wraps (20cm)
method: 1. 2. 3. 4.
18
Mix all ingredients except tortillas in a large bowl. Spread 1 cup of bean mix on one side of each tortilla, then fold over the other side to enclose filling. Place in a heated sandwich press and toast for 2 minutes or until crisp and cheese melted. Cut each tortilla into 3 triangles and serve immediately.
HepatitisWA Newsletter // April 2018
Source: LiveLighter ÂŽ State of Western Australia 2013. Reproduced with permission. For more healthy recipes and tips visit www.livelighter.com.au
HepatitisWAâ&#x20AC;&#x2122;s Deen Clinic is open for hepatitis C treatments. Available to people living with chronic hepatitis C including those who continue to use drugs and/or who do not have a GP.
100%
Bulk-Billing
Make an appointment on (08) 9227 9800. Our services include: Hepatitis C testing
134 Aberdeen St, Northbridge WA 6003
Hepatitis C treatment
P: (08) 9227 9800
Support Referrals
E: info@hepatitiswa.com.au W: www.hepatitiswa.com.au HepatitisWA Newsletter // April 2018
19
Exciting changes occurring Name change
Change in clinic hours
WA Substance Users Association (WASUA) has had a name change to Peer Based Harm Reduction WA. The service is still in the same location with the same great people, just a new name.
The Health Clinic based at Peer Based Harm Reduction WA has also had the hours changed. The Health Clinic is now available on Tuesday, Wednesday and Thursday (for clinic times refer to page 21).
The name change came about from conversations with consumers and staff. Basically, we want a name that reflects the range of services we offer and especially highlights the great work we do as the only peer based service in WA providing an NSEP, among other services.
The change in hours provides our Nurse Practitioner, Leanne, additional hours to run the Health Clinic. Leanne has nearly two decades of specialised experience in viral hepatitis and advance liver disease. Leanne offers a range of services and helps to reduce barriers faced by consumers when accessing health services.
Change in opening hours
New ServiceS:
Another change that has occurred is that some of the opening hours have been updated. On a Friday we now close at 5pm, and on the weekends we are open between 1pm and 4pm.
Resource and Workforce Development Over the next three months Peer Based Harm Reduction WA will be working with consumers to develop a hard copy resource and some
20
HepatitisWA Newsletter // April 2018
PEER BASED HARM REDUCTION WA’S DOMAIN social media clips. These resources will increase access for consumers to negotiate the systems of care, specifically the health care system and the social support system.
A Peer Support worker and a CaLD
Engagement Officer will focus on working with vulnerable and disadvantaged members of the community in the City of Stirling, who may be hard to reach and are not currently accessing services.
Additionally, Peer Based Harm Reduction WA will also undertake peer led workforce development, by providing a number of information, education and training sessions to organisations. This project will focus on the area of Wanneroo, Clarkson, Midland, Mundaring and Kalamunda. So if your service is based in any of these areas then contact Peer Based Harm Reduction WA for more information.
Peer Based Harm Reduction WA are currently finalising Service Level Agreements to deliver these services. Funding is provided through WAPHA via Neami National. If you currently provide a service or are interested in receiving a service and a located in the City of Stirling, please contact Peer Based Harm Reduction WA for more information.
Intensive Outreach Service
New contact details:
Working with the existing services in the City of Stirling, Peer Based Harm Reduction WA will implement an Intensive Outreach service for people who are experiencing problems related to their use of AOD’s. This project will focus on supporting people to access services to improve their health and wellbeing.
Phone: (08) 9325-8387 Fax: (08) 9325-6152 Postal address: PO Box 8003, Perth WA 6849 Street address: Suite 21-22 7 Aberdeen Street, Perth WA 6000 Email: info@harmreductionwa.org Website: www.harmreductionwa.org
PERTH
SOUTH WEST
Phone 0418 739 372 Office (08) 9791 6699
(08) 9325 8387 harmreductionwa.org
Perth NSEP Mon - Wed and Fri: 10am-5pm Thurs: 10am-8pm Sat & Sun: 11am-4pm Clinic Hours Tues: 10:30am - 1pm & 2pm- 4:30pm Wed: 12pm - 4pm Thurs: 10:30am - 1pm & 2pm- 4:30pm Closed Public Holidays Peer Based Harm Reduction WA provides a number of services on premises at 22/7 Aberdeen St, Perth WA 6000, including: • • • • • • • • •
NSEP (Needle and Syringe Exchange Program) Free hep A and B vaccinations for hepatitis C positive people Free blood testing in a friendly confidential environment Drug treatment support and referral Peer education and training Street-based outreach Advocacy and support for users Safe injecting and safe disposal education and resources Hepatitis C/blood borne virus information and resources
97 Spencer St, Bunbury (entry via Rose st) Opening Hours: Monday to Friday 10am - 2pm.
Margaret River Busselton Manjimup
South West Mobile provides a mobile Needle Syringe Exchange Program (NSEP) at the following locations and times: Tues: 3pm-4pm Hospital Carpark Tues: 5pm-7pm Hospital Carpark Thurs: 12pm-1pm Hospital Carpark * FREE equipment on exchangeable items * FREE resources and helpful information
A confidential outreach service is also available throughout the southwest from Monday to Friday, for people who cannot attend the site locations. Phone 0418 739 372 to arrange a suitable time.
HepatitisWA Newsletter // April 2018
21
Where Do I go to get hep C testing & treatments? Hepatitis C treatments are now available and all GPs are eligible to prescribe. However, as these are new treatments, some GPs may be reluctant at this stage to prescribe as they are not familiar with them and are still learning about the medications and processes. Speak to your GP and find out if they, or another GP in the practice is hepatitis C treatment ready. For those people whose GPs are unable at this stage to prescribe we have put together a list of doctors who are currently ready to prescribe.
In so doing, HepatitisWA is not promoting any one doctor or practice over another or suggesting that these are the only doctors who are prescribing. This list is updated on a regular basis via our website as more doctors take up prescribing. If you are a GP or Pharmacy that offers new hepatitis C medicines and would like to be added to our list, please email your information to eto@hepatitiswa.com.au.
PHARMACY NAME
PHARMACY LIST ADDRESS
PHONE
Albany Community Pharmacy
18 Pioneer Road,Albany WA 6330
(08) 9841 1532
Amcal Max Albany
262 – 264 York St, Albany WA 6330
(08) 9842 2036
Amcal Max Tuart Hill
85 Wanneroo Rd, Tuart Hill WA 6060
(08) 9349 1065
Busy Bee Pharmacy
201-205 William St, Northbridge WA 6003
(08) 9328 7885
Chemist Warehouse Northbridge
4/347-349 William St, Perth WA 6000
(08) 9328 8202
Chemist Warehouse North Perth
412 Fitzgerald St, North Perth WA 6006
(08) 9228 8474
Chemist Warehouse Perth
1/109 Murray St, Perth WA 6000
(08) 9325 7948
Chemist Warehouse Victoria Park
348 Albany Hwy, Victoria Park WA 6100
(08) 9361 8917
Craven’s Pharmacy
2/553 Hay St, Perth WA 6000
(08) 9325 8810
Epic Pharmacy Hollywood Hollywood Private Hospital
101 Monash Ave, Nedlands WA 6009
(08) 9389 3500
Epic Pharmacy Mt Lawley Mercy Hospital Mount Lawley
15 Thirlmere Rd, Mount Lawley WA 6050
(08) 9370 9222
Joondalup Hospital Pharmacy
Ground Floor – Medical Centre West Joondalup Health Campus Shenton Ave, Joondalup WA 6027
(08) 9400 9900
McKenzies Chemist
689 Beaufort St, Mount Lawley, WA 6050
(08) 9271 6870
Optimal Pharmacy Plus Armadale
28/193 Jull St, Armadale WA 6112
(08) 9393 1200
Optimal Pharmacy Plus Balga
7 Fieldgate Square, Balga WA 6061
(08) 9342 2212
Optimal Pharmacy Plus Meadow Springs
25 Meadow Springs Dr, Meadow Springs WA 6210
(08) 9582 0119
Optimal Pharmacy Plus Stirlings
Shop 16, Stirling Arcade Sanford St, Geraldton WA 6530
(08) 9921 1965
Priceline Albany
Dog Rock Shopping Centre, 1/324 Middleton Rd, Albany WA 6330
(08) 9841 4377
Priceline Pharmacy Hay Street
810 Hay St, Perth WA 6000
(08) 9321 0699
Scarborough Beach Pharmacy
241 West Coast Highway, Scarborough WA 6019
(08) 9341 1133
Scarborough 7 Day Chemist
Shop 3, 23 Scarborough Beach Rd, Scarborough WA 6019
(08) 9245 1950
SouthWest Hospital Pharmacy
St John of God Bunbury Hospital, Cnr Robertson Dve & Bussell Hwy, Bunbury WA 6230
(08) 9729 6290
Subiaco 7 Day Pharmacy
157 Rokeby Rd, Subiaco WA 6008
(08) 9388 1203
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HepatitisWA Newsletter // April 2018
MEDICAL PRACTICE LIST BULK BILLING?
PRACTICE
ADDRESS
PHONE
Dr. Nada Andric Dr. David Hoffman Dr. Lindsay Mollison
HepatitisWA (Deen Clinic)
134 Aberdeen St, Northbridge, WA 6003
(08) 9227 9800
Dr. Hillary Snell
Bayswater Medical Group
433-435 Guildford Road, Bayswater 6053
(08) 9272 3111
Dr Willie Smit
Boulder Medical & Occupational Health Centre
49 Burt Street, Boulder, WA 6432
(08) 9093 1044
Dr. J. Mudhar Dr. T. S Khoo
Carousel Medical Centre
1/7-9 Pattie St, Cannington WA 6107
(08) 9258 1000
Dr. Simon Hazeldine
Coastal Gastroenterology
Unit 75, Level 4, Wexford Medical Centre, Murdoch Drive, 100 Barry Marshall Parade, Murdoch WA 6150
(08) 6389 0631
Nurse Practitioner Jenny Wilton
Cravens Pharmacy
2/553 Hay St, Perth WA 6000
(08) 9325 8810
East Fremantle Medical Centre
12 Silas St, East Fremantle WA 6158
(08) 9339 4116
Dr. Linda Muntz Dr. Mark Smith Dr. Stuart Paterson
Ellen Health
1/91 Hampton Road (Corner of Wray Ave and Hampton Rd), Fremantle WA 6160
(08) 9239 0200
Dr Ovidiu Merlas
Forrest Road GP
50 Forrest Road, Armadale, WA 6112
(08) 9497 1900
Fresh Start Recovery Programme
65 Townshend Rd, Subiaco, WA 6008
(08) 9381 1333
Dr Ohireime Ovbiagele
GOMED Hannan Street
130 Hannan Street, Kalgoorlie, WA 6430
(08) 9026 1900
Dr. Fergus McCabe Dr. Belinda Wozencroft Dr. Ric Chaney Dr. Goran Pervan
GP on Beaufort
691 Beaufort St, Mount Lawley, WA 6050
(08) 9262 8600
Dr. Lindsay Mollison
Hollywood Specialist Centre
15/95 Monash Ave, Nedlands, WA 6009
(08) 9346 6000
Mandurah Medical Centre
265 Pinjarra Rd, Mandurah WA 6210
(08) 9535 4644
Mount Hawthorn Medical Centre
81 Scarborough Beach Road, Mount Hawthorn WA 6016
(08) 9444 1644
NAME
Dr. Grace Vivian
Dr. Wendy Lawrance
Dr. Samuel Komakech
YES
YES
YES
Dr. Peter Winterton Dr. Frank Jones Dr. Rupert Backhouse Dr. Hermann Meyer
YES
Murray Medical Centre
34 – 36 Minilya Parkway, Mandurah, WA 6210
(08) 9535 1166
Dr Anne Cynthia Asokananthan Dr Ritthy Sovann
YES
Riverton Medical Centre
7/2 Madeira Rd, Parkwood, WA 6147
(08) 9457 1999
Dr Michael Hale
Rockingham Medical Centre
18 Civic Blvd, Rockingham WA 6168
(08) 9557 1111
Dr Anita Campbell Dr Jane McCulloch
Rondel Family Practice
Unit 25/153 Trappers Drive, Woodvale WA 6026
(08) 9409 6060
Dr Stephen Hinton
St John of God Bunbury Hospital
Suite 10 St John of God Hospital Bunbury 6230
(08) 9721 8833
Prof Gary Jeffrey Dr. Michael Wallace
The Liver Centre WA
1st Floor, Suite 10, 2 McCourt St, West Leederville, WA 6007
(08) 6163 2800
HepatitisWA Newsletter // April 2018
23
my promise to myself this year is to...
get rid of
hep C!
need help to access treatments? call our helpline on 9328 8538 or visit our website hepatitiswa.com.au