#100 HepSA Community News

Celebrating 100 Issues

A NOTE FROM THE EDITOR

Welcome to the 100th Hepatitis SA Community News. This issue also marks the launch of a new Community News website, merging the magazine with our HepSAY blog. The new online HepSA Community News platform will give readers a richer mix of content, accessible from computer and mobile devices.

While we grow and adapt to the changing media environment, we remain aware of barriers to technology due to income, geography, lived experience and opportunities. We believe print media is important in lowering these barriers, and we will keep printing as long as it is sustainable.

With this issue, we have also published a retrospective supplement, looking back at past issues. We hope it gives you a picture of our 26 years of news and story sharing, and an idea of how much the magazine has grown and evolved. We hope you will take the next step with us and explore our online content as well.

Drop in for a visit—may it be the first of many!

hepsa.asn.au/communitynews

Editor: James Morrison

Correspondence: Please send all correspondence to The Editor at PO Box 782, Kent Town, SA 5071, or email editor@ hepatitissa.asn.au.

Contributors: Cecilia Lim, Joy Sims

Some photos in this publication may have been altered to disguise identifying details of members of the public.

This resource was prepared and printed on Kaurna Country.

Disclaimer: Views expressed in this newsletter are not necessarily those of Hepatitis SA. Information contained in this newsletter is not intended to take the place of medical advice given by your doctor or specialist.

We welcome contributions from Hepatitis SA members and the general public.

SA Health has contributed funds towards this program.

ISSN 2651-9011 (Online)

Liver Cancer Roadmap

The elimination of hepatitis B and hepatitis C is one of the key strategies outlined in a set of guidelines addressing the alarming rise of liver cancer cases and associated deaths in Australia. Titled the Roadmap to Liver Cancer Control in Australia, other actions recommended in the plan include community awareness raising, and the improvement of access and support to services for communities at higher risk of liver cancer. Launched in March 2023, the Roadmap identifies priorities needed for the next two, five and ten years to reduce disease burden and rate of liver cancer, and improve outcomes and survival rates for Australians affected by the disease.

Among the actions recommended are:

• improvement of data usage for more effective targeting of at risk groups, prevention strategies such as the elimination of hepatitis B and C,

• raise awareness in higher risk communities including Aboriginal and Torres Strait Islander people and culturally and linguistically diverse groups,

• increase awareness of risk factors and prevention among community and primary health care workers,

• earlier identification of hepatitis B, hepatitis C and advanced liver disease in primary care settings,

• improved screening for advanced liver disease and monitoring of hepatocellular carcinoma (HCC) with greater availability of tests and equipment,

• culturally friendly access to diagnosis, treatment and support for people with HCC or at risk.

Liver cancer is the fastest growing cause of cancer-related deaths in Australia, having rapidly increased in incidence and deaths in the last 40 years. The incidence of liver cancer has risen from 1.8 per 100,000 in 1982 to 8.7 per 100,000, and this trend is expected to continue unless steps are taken to prevent the development of the disease in people who are at risk (see diagram below) .

While there are many types of liver cancers, the bulk of liver cancer cases are HCC. This means a significant proportion of liver

cancers can be prevented by eliminating the transmission of hepatitis B and hepatitis C which are the leading causes of the HCC.

Early detection of hepatitis B and hepatitis C infection, followed by treatment to cure for hepatitis C, and monitoring of hepatitis B with appropriate clinical management will go

In South Australia:

Cancer Council SA (CCSA) Manager of Prevention and Advocacy, Christine Morris, says the CCSA welcomes the launch of the Roadmap and supports the Priority actions.

“We are building relationships with key organisations in order to support activities that are already underway,” she said. “In future we hope to broaden our work in liver cancer control to focus on prevention, immunisation, advocacy and support, achieved by building effective partnerships and working in culturally appropriate ways.”

She pointed out that the current CCSA’s key services are in line with the Roadmap’s priority actions. This includes its confidential information and support line Cancer Council

13 11 20. “It is open to anyone,” said Ms Morris. “People living with cancer, their families, carers and friends, the public, workplaces, and health professionals. We can talk to you about the effects of specific types of cancer and how to cope with treatments and side effects, provide a listening ear for you to share your experiences, provide emotional and practical support and link you to a range of support services, such as legal and financial assistance and support groups.”

In addition, CCSA provides free, nonjudgemental and confidential counselling services for patients, their family and/or carers, including bereavement counselling. It also offers low-cost accommodation for patients and their carers travelling from regional areas to Adelaide for treatment and cancer-related appointments.

a long way towards reducing the development of liver cancer in people currently living with these viruses. Management of close contacts, with vaccination where applicable, and other harm reduction strategies to reduce the transmission of these two viruses will ultimately contribute to the lowering of liver cancer incidence.

Liver cancer risks also include behavioural and metabolic factors that are associated with other chronic diseases. They include excessive alcohol use, tobacco consumption and the excess accumulation of fat in the body. Accordingly, the Roadmap recommends the funding of preventive health actions for non-communicable diseases, especially around tobacco control.

Recognising the higher risk of liver cancer in some population groups, the Roadmap has called for targeted education campaigns to increase liver cancer awareness in Aboriginal and Torres Strait Islander communities and culturally and linguistically diverse groups. In addition, it is calling for improving access for these communities by providing culturallyfriendly support to help patients who are receiving HCC care, navigate the health system.

The Roadmap also pointed out the need to link collected data to surveillance and screening of liver cancer. Applying data around patient characteristics and socio-economic factors to liver cancer diagnoses and outcomes will support better identification of people at higher risk of developing liver cancer and facilitate measures to reduce liver cancer incidence and improve outcomes.

The Roadmap to Liver Cancer Control was developed and published by Cancer Council Australia, funded by the former Department of Health, now the Department of Health and Aged Care.

Read the full report at bit.ly/liverroadmap.

Waking to a New Life

Maureen Cook went from worrying about how long she had to live to planning for a whole new life. It only took her 23 years.

“I found out I had hepatitis C in 2000 when a diligent and insightful GP decided to test me for it after she discovered I had hepatitis B back in 1975. I’d cleared the hep B then and didn’t think about it anymore. Didn’t know I had hep C,” she recalled.

“Well, when I got my hep C diagnosis, I started worrying about how long I would live for, and worried about passing the virus to other people. I’d look at pictures of the virus and thought it looked really scary.”

Because there was no effective cure back then, Maureen looked into, and tried complementary therapies. “I tried acupuncture, herbal remedies… with no results,” she recounted. Then, in 2009 because she had liver cirrhosis, Maureen was put on interferon treatment.

“That went horribly wrong—I almost died,” she said.

She kept a visual diary during the first treatment but had to stop because she became too ill. She had ended up in intensive care for nine days with double pneumonia and septicemia. “My bone marrow had stopped producing the vital blood cells to fight the good fight for me. Remarkably I survived, after I was not expected to,” she said.

“I had to go to St Margaret’s hospital to learn to walk again. My memory and comprehension was really bad.”

In 2011, she began a series of five selfportraits documenting her difficult journey to recovery. She named the series Waking the Dead. In her artist statement for an exhibition where her art was presented. Of this series, she said: ‘Waking the Dead 1-5’

documents my struggle to be present in the world as my consciousness dragged itself to the surface ... I had to relearn thinking, comprehending, remembering, doing and to be able to stand up and walk again.

“I was attending an art group in Stepney, learning painting. The artwork was my way of processing all that,” she explained. “The series of five portraits was me coming back to life. It was almost like a spiritual experience.”

In 2015 she had a call from the Flinders Medical Centre offering her to be part of a trial of new direct acting antiviral drugs.

“The new treatment was different. The only side effect I had was insomnia. My asthma

The last painting – Relief – in Maureen’s triptych depicting the terror, despair and relief of her interferon treatment experience.

played up a bit, but it was manageable. I was able to continue to go to work.”

For Maureen, the difference in life pre and post cure didn’t relate so much to how other people treated her, but more to how she felt about herself.

“I had internalised my stigma because I felt I was stupid … blaming myself. I thought, being a nurse, I should have taken more care. Now I’m cured, I don’t feel that selfblame anymore. I can put it all behind me.

“I hadn’t encountered much stigma overtly, from others. Mostly support in fact. I discussed my hep C with friends and family when I was first diagnosed. They only gave me support.

“Initially I chose not to disclose to my workplace that I had hep C. However, the interferon treatment went for 48 weeks which

meant I had to take a year’s leave without pay due to the severity of the side effects.

“Even though the first treatment went horribly wrong, and I ended up in hospital for 10 weeks, the time off work and recovery really helped with my burn-out from work.

“After the horror of my first treatment, I had decided to take a positive attitude and accept that I had to learn to live with the chronic disease.

“Life post-cure was… a tremendous relief. It was wonderful knowing that I’m no longer infectious, and not able to pass the virus on to others.”

A nurse for 47 years, 38 of them in mental health, Maureen continued working after

Maureen in her studio

Washing up on Shore: the storm is passing and clouds breaking open with the sunshine of a new day.

clearing hepatitis C, until the COVID-19 pandemic hit.

“I took a couple of weeks off, and kept on taking more,” she said with a laugh. “That’s when I retired from nursing, in July 2020.”

After a three-year hiatus, unwinding and reviewing her new life, she’s ready to get back into work—not as a nurse but in other areas that draw on her lived experience and her relationship with art.

“As a mental health nurse, I worked in many areas and in my last ten years, I was part of a SA Health community psycho-social rehabilitation team. We provided group programs on living skills, psycho-education, healthy living, fitness, recreation, youth

programs, art, liaising with further education and community centres and many more activities. We also worked with the inpatient unit Cramond Clinic and an NGO return to work program.

“I was trained in acceptance and commitment therapy, and I used that to teach people skills to manage their own emotions and life challenges. Art was an important part of rehab as a way of looking at the world, identities, and so on. The people I really enjoyed working with were the carers.

“Art is a good way to help people process their experiences and emotions and being with yourself. A way to engage with people. A very good mindful exercise.”

In the three-year break, Maureen reviewed the paintings that she had done on her journey, and decided to set up a studio so she could paint more and run workshops from it.

She believes art is for everyone, not only those who are “artistic” in the conventional sense. “It can work for people who may not be usually interested in art,” she explained. “Like creating mandalas, for instance… it’s a way to engage with people, get people motivated. It can also be an outlet.”

Maureen said looking at her artwork brought back difficult memories but also gave her direction for the next chapter of her life.

“Emotionally it was a really difficult time. Hep C was such a big part of my life for so long, and I didn’t know for so long that I had it. Having access to the new treatment was really life-changing for me and clearing the virus was one of the best things that happened to me.

“When I look at the artwork it brings it all back and gives me a stronger resolve to make a contribution with my life.”

SEE MORE:

https://bit.ly/maureencook

Hepatitis C Drug Resistance

Direct-acting antiviral drugs (DAAs) to treat hepatitis C have proven to be a spectacular success, being able to cure more than 95% of people who have been living with the virus. However, a growing issue has implications for the design of future DAAs, and that is the ability of the hepatitis C virus—like all viruses—to mutate. Mutant versions of viruses can “learn” to defeat the medications used to treat them by changing their structure or the way they interact with the bodies they infect.

When they help the virus evade the effects of medication, we call these changes “drug resistance mutations” (DRMs), and they can make it much harder to cure infections. When a drug-resistant version of a virus becomes the dominant one, it can make a previously useful drug completely ineffective. While multiple DRMs have been observed for all currently used antivirals, up until now it has not been known how this process actually allows the hepatitis C virus to overcome the effects of the medications. New research, published in Nature Communications in November, has started to dismantle this ignorance.

Many DAAs work by targeting a part of the hepatitis C virus called the nonstructural 3 (NS3) protein. The NS3 protein is created by hepatitis C to do a number of things, including allowing the virus to replicate in the human body.

The research study, by Hang Zhang, Ahmed Abdul Quadeer (both based in Hong Kong) and Matthew R. McKay (based in Melbourne) looked specifically at the DAAs which target the NS3 protein, and found that a process call epistasis was significantly involved in growing drug resistance.

In simple terms, “epistasis” is like teamwork between different genes or mutations. Imagine you have a team of players in a game. The performance of one player might depend on how well another player is doing. If they work together well, the team performs better, but if there’s a problem between them, it might affect the whole team’s success.

In genetics, it’s a similar process. Epistasis is when certain genetic changes or mutations work together in a way that influences how they function or how they affect a trait. So, it’s like the genes are cooperating or interfering

Diagram of the RNA of the hepatitis C virus, with the section that codes for NS3 shown in yellow (Image courtesy of the International Journal of Molecular Sciences)

with each other, and this teamwork can have a big impact on how things turn out, like in the case of drug resistance mutations in the hepatitis C virus.

The study showed that hepatitis C is extremely good at mutating under the selective pressure of antiviral drugs, and that the easiest way for it to do this in a way that makes the drugs work less well is by modifying genes that, by epistasis, affect the NS3 protein. This indicates that future

antiviral research and development needs to focus on ways to overcome that. This might mean creating antivirals that affect other parts of hepatitis C than the NS3 protein, or perhaps ones which attack NS3 in a different way that mutations in other parts of the virus can’t overcome.

READ MORE:

nature.com/articles/s41467-023-42550-6

Cross-section of the hepatitis C virus, showing (in yellow) the folded-up RNA stored inside (Artist’s impression)

In Memory of Mark Tiller

Mark Tiller started working in harm reduction as a volunteer with SAVIVE and later came to Hepatitis SA as a member of the CNP team. He died earlier this year after a long period of illness, and will be sorely missed by his colleagues and friends at Hepatitis SA.

MARGIE

Being around Mark when you were in a good people-watching spot, like the pub, was like getting free entertainment. He would chatter away, telling me life stories about each person in the pub. When I say life stories that’s exactly what I mean. He would tell me details about their childhood, what their parents were like, family trips, birthday

parties, school life, the first girlfriend that was nasty—everything. Down to the wart on their foot that talks and abuses people. How they can’t wear sandals because the wart gets them beaten up. Mark’s mind was quick and he was whip-smart. Much of his humour was very dark and went over people’s heads. Mark and I had a love for B-grade movies. The trashier the better. We would spend hours watching the worst movies and giggling our heads off. In the last few years both of us struggled to stay awake. I’d fall asleep straight away and wake up half way through just as he was falling asleep. So maybe we didn’t see that many recently. So many times I would go to bed just as Mark was putting another DVD on. When I got up in the morning the same movie was still playing. A few times I dared to get up and turn it off after he had been asleep for hours.

“Hey! What? Hmf! GRRRRR! I was watching that!” Every time.

The last time I saw Mark we decided to go to Windy Point to watch the sunset. We trotted off with snacks and drinks, in anticipation of the beautiful feat of nature that is a dazzling sunset. As the sunset got lower we diligently kept our eyes focussed on the horizon. Didn’t want to miss it.

One minute the sun was there, the next it was gone. No orange sky, no colours, no nothing. It was the worst sunset either of us had ever seen. We just sat there staring waiting for something to happen. It didn’t.

Now every time I see a bad sunset, I’ll think of Mark.

I don’t think I have come to terms with Mark not being here anymore. I am still expecting a txt at 11:30pm telling me ‘Blackula” is on Channel 44.

I feel privileged that Mark let me into his world. He held his friends close to his heart at all times. I am going to miss him terribly. He was unique.

CAROL

Mark had a vast knowledge of harm reduction and safer injecting and, as the Noarlunga CNP peer, Mark was well known to many in the southern community. I’m sure I won’t be the only one who will miss Mark’s larrikin sense of humour.

BERNADETTE

It is a terrible loss to our community. He will be sadly missed by so many. Mark was a wonderful mentor and extremely knowledgeable on all things related to harm reduction and safe injecting practices.

He was easy to talk to about anything and everything. He had a no-nonsense approach with the clients, not allowing anyone to pull the wool over his eyes, knowing if you give ‘em an inch, they will take a mile. He used that last quote often, in a joking manner. He had a wonderful sense of humour, and he would often make me laugh. He never seemed to let things faze him.

When he did get unwell and had increasing bouts of absent days, all the regular clients would ask after him, and they would send their wishes, want him to get well and get back. Many of the Noarlunga clients that knew him at work (and in the community after hours) thought he was a top bloke and wanted to know he was OK. Everyone wanted to know that he was getting better. I myself never thought I’d see the day he wasn’t here—until retirement, that is. It was such a shock, and so heartbreaking to hear he’s no longer with us. I will miss him greatly and remember him fondly.

LISA

Whenever I saw Mark, I would get a Grong Grong soundtrack in my head, or tunes from other Adelaide punk/grungy bands, in

particular the lyric, “I’ve got a little story to tell, ‘bout a man, said he came from hell…”. We would often share memories of bands such as Grong Grong, Exploding White Mice, and a multitude of others. We’d recall the stickiness of the floor at the Tivoli and laugh. He had a great laugh—if you knew him, you can hear it in your head now, can’t you? Mark himself is his own bit of Adelaide history and will be missed by many, including me. Rest however you want to, Mark.

PENNI

Mark’s wit, knowledge and support to teammates will be remembered and missed.

JUSTIN

Mark was someone who helped me look at things from different perspectives, and always pulled me up when my information or ideas about delivering harm reduction messages started to go off-track. I always appreciated having him as a sounding board in our meetings and group emails. He will be missed.

Alcohol No Barrier to SVR

The use of alcohol does not decrease the chances of sustained virologic response (SVR) among patients initiating direct-acting antiviral (DAA) therapy for chronic hepatitis C virus infection, according to a study published in September in JAMA Network Open. Sustained virologic response means that the hepatitis C virus is not detected in the blood 12 weeks or more after completing treatment--something that in almost all cases means that the virus has been cured.

Dr Emily J. Cartwright from the Atlanta Veterans Affairs Medical Center and her colleagues evaluated whether alcohol use at DAA treatment initiation is associated with a decreased likelihood of SVR. The extremely wide-ranging analysis included almost 70,000 patients with chronic hepatiitis C who started DAA therapy between the start of 2014 and midway through 2018.

The researchers found that 94.4% of patients achieved SVR. Overall, 46.6% of participants were abstinent and not considered alcoholics, 13.3% were abstinent but had lived with alcoholism, 19.4% had

lower-risk consumption, 4.5% had moderaterisk consumption, and 16.2% had high-risk consumption, including alcoholics who were drinking heavily.

Remarkably, there was no difference in SVR across alcohol use categories, even for patients with high-risk consumption, when adjusted for other factors. Furthermore, there was also no interaction by stage of hepatic fibrosis.

“These findings suggest that restricting access to DAA therapy on the basis of alcohol use creates an unnecessary barrier for patients and challenges HCV elimination goals,” the authors write. Based on this research, the argument for DAA therapy being made available to everyone living with hepatitis C becomes even stronger.

In Australia, DAA treatment for hepatitis C is available on the PBS, and has a cure rate of better than 95%.

READ MORE:

jamanetwork.com/journals/ jamanetworkopen/fullarticle/2809930

SAPOL Education

The Hepatitis SA Education team has successfully negotiated with SAPOL Training & Development branch to deliver ongoing blood safety and viral hepatitis training and education sessions to all operational SAPOL personnel.

In the past Hepatitis SA Education Team have delivered training & education to SAPOL, but this has always been a little ad hoc, with no set times, locations, timeframes or even standard length of the education. This will all change with the new ‘Blood Safety & Viral Hepatitis’ education program. These sessions will have a SAPOL Health Safety & Welfare code attached, with the

sessions having an operational focus with key messages and being SAPOL-compliant.

Some of the key messages that will be discussed include understanding hepatitis, blood-borne viruses, vaccinations, treatments and transmission risks. As an operational police officer what do you do if you have received a needlestick injury, or had a blood exposure? What even constitutes an exposure? Who do you notify? What about blood on your clothing? Myths about viral hepatitis will also be discussed and dispelled.

We are hoping to commence this training early in 2024.

Celebrating 100 Issues!

Before social media and online chat, there were newsletters. People read them, wrote letters to the editor and contributed essays. That’s when our Community News was born— back in 1997, as a platform for discussion and sharing knowledge—part of a nascent hepatitis C information and support service.

Hepatitis SA veterans, Deborah WarnekeArnold and Fred Robertson remembered those heady days. “We had a tiny room at DASSA on Fourth Avenue, one project officer, Colin, and a one-day-a-week admin person, Julie,” Deborah recalled. “We were getting calls from people wanting more information. We thought, we’ve got all this information from the readings we’re doing, we should share it with a newsletter.”

The Hep C Community News started with an editorial group of five and enthusiasm leaping off its eight pages. Sections included Book Review, Real Life, Diet, and a Dear Doctor column with replies from Dr Robina Creaser, and occasionally, other relevant specialists.

The newsletter was rich with news on the Hepatitis C Council SA (HCCSA) and its support group activities, as well as information on transmission, diet, treatments, legal rights and mental health.

Deborah joined the Council in 1997 and hasn’t looked back since. By mid1999 she was editor of the Community News. “Doug Mellors [the writer behind ‘Doug’s Desk’] taught me how to look up information. I’d go to the Barr Smith library and spend hours there reading up on the latest research. I was so proud of my membership card. I’d be there, putting my head down, reading as much as I could, hoping people would think I’m a student,” she said, laughing.

“I was editor from issues 9 to 20. I learnt all my computer skills from working at the Council, especially on the newsletter—touchtyping and layout with Publisher. It was very much a community learning together.” (See Deborah’s story in issue 16.)

Editorial group members working alongside Deborah included Doug Mellors, Sharon Drage, and Fred Robertson, with proofreading support from acting manager Leslie Whiteman. Subsequent issues listed HCCSA Coordinator, Kerry Paterson, as proofreader.

Deborah remembered key events reported in the magazine. One such highlight was the first Hepatitis C Awareness Day in SA. Issue 12 (Autumn 2000) reported on the Awareness Day launch by the Minister for Disability Services, Robert Lawson, a lived experience forum facilitated by Adelaide Mayor, Jane Lomax-Smith, and the launch by Equal Opportunity Commissioner, Linda Mathews, of a pamphlet jointly produced by HCCSA and the Commission. It also

Awareness-Day education session run by HCCSA, the Drug and Alcohol Services Council, Marion Youth Centre and COPE.

Remarkably, we learn from issue 44 (July 2009), that Dr. Jane Lomax-Smith again launched the Council’s hepatitis C awareness campaign, by now part of a world campaign: World Hepatitis Day. This time she was doing it as Minister for Mental Health and Substance Abuse, on behalf of Health Minister, John Hill; that launch also coincided with the introduction of Council’s newly revamped website.

Perhaps the most striking difference between the very early Community News and now, is the lively community engagement: questions to the doctor, angry letters, thank you letters, personal stories and so on—the sort of things that happen online these days.

Even within the first few years, however, as the information in the magazine got more comprehensive, even though letters to the editor continued to come in from time to time, spontaneous communication declined as the content answered questions

editorial and management committees, and had contributed many a book review as well as articles on complementary therapy.

“The changes in the organisation were inevitable—it’s a natural growth and progression from an ad hoc community group to a professional NGO that can influence decisions that affect the community.”

He remembered turning up at the Council for information and feeling so welcome that he joined as a member and a volunteer. “It’s different now but it also means things are done with professional staffing, with greater awareness of rules and guidelines which means as an organisation we can do more,” he said.

Fred said the Community News has become more professional in presentation and content, as befits the flagship publication of a peak service organisation. “We lose some spontaneity in the process, but we also gain a lot—more credibility, access to decisionmakers, more funding and greater reach,” he added.

“The changes in the Community News pretty much reflect the changes that had to with the Council,” said Fred who was on the

There is no formal archive recording the history of Hepatitis C Council SA (now Hepatitis SA), but the Community News does a pretty good job filling that gap.

Its 99 issues to date chart the organisation’s growth from a small group of committed individuals with varying skill levels, to a peak organisation with highly skilled staff providing on-going support and services, reaching more people and having input into state-level decision-making that affects the hepatitis sector and community.

Read all 99 issues at bit.ly/hcnstack, and see this issue’s supplement for some highlights from the past!

A diagnosis of hepatitis can be overwhelming— the worry over effects on health, wellbeing, work, relationships, and life in general, can be all-consuming. But with successful cures available (for hep C) and effective management (for hep B) life can still be lived well.

The following resources have reliable information about how to manage symptoms, maintain relationships, keep physically and mentally well—and who you do, or don’t, have to tell about your hepatitis status.

Contact us at admin@ hepsa.asn.au if you would like assistance in accessing these, or any other, resources.

In Our Library Living well with hepatitis

Life relationships and hepatitis B

Hepatitis SA, Adelaide, 2023. 2p. Practical advice woven through a personal account of someone seeking information about how to manage a diagnosis of hepatitis B in the family: whether to tell other family members, how it would affect relationships, how it might be transmitted to other family members, and how to find a hep B friendly doctor who would speak the same language. bit.ly/lifehepb

Disclosure

Hepatitis NSW, Sydney, 2023. 3p. factsheet

A useful factsheet that covers: who do/don’t you have to tell if you’ve been diagnosed with hep C or B (and the legal implications): when should I tell someone that I have hepatitis? What should I say? - And some

possible outcomes of disclosing this information. bit.ly/disclosure_hep

Hep B Winners - B형 간염과 살아가기

Hepatitis NSW, Sydney, 2022. Online chat

The purpose of this chat group for Korean speakers is to share useful information, and to encourage each other with lifelong monitoring to manage hep B. Members currently include Hepatitis NSW’s Lived Experience Speakers and the winners of Hep B Writing Competition. Discussions have so far included pregnancy and hep B, and how to get liver clinic services without extra cost.

bit.ly/hepbwinners

Nutrition in advanced liver disease for weight management

Queensland Health, Brisbane, 2022. 7p

Suggestions for people with chronic liver disease, in particular advanced liver disease (cirrhosis), who may be overweight and have been advised to lose weight or prevent weight gain. It includes advice about how to maintain muscle mass, exercise, keeping up with constant protein intake, lowering salt intake and general meal planning hints.

bit.ly/liver_weightmgmt

Exercise for healthy livers

Hepatitis SA, Adelaide, 2022 (rev). 3-fold brochure

Information about why exercise is important, how it helps, what types of exercise are useful, how to set goals and stay motivated. Read only online (important note: ad blocking apps may need to be turned off to view complete ISSUU resources). Free printed copies are available: email admin@hepsa.asn.au. bit.ly/healthyliver_exercise

Can pickle juice reduce cirrhotic muscle cramping?

University of Michigan, Ann Arbor, 2022. 3p article review. Compared to other cirrhosisrelated symptoms muscle cramps can have the highest impact on daily quality of life. Liver experts found that the acid in pickle brine triggers nerves in the back of the throat, which turns the cramp off.

bit.ly/liver_cramping

Nutrition in advanced liver disease

Qeensland Health, Brisbane, 2021. 6p

For people with chronic liver disease, in particular advanced liver disease (cirrhosis), who are losing weight without trying. It contains information on how diet can help you manage this condition: how to increase protein and lower salt intake, how to manage fluid intake and fluid build-up in the body. With suggested meal and snack plans. bit.ly/advliver_nutrition

How chronic stress changes the brain: and what you can do to reverse the damage

The Conversation, Melbourne & Sydney, 2020. 4p

This article outlines some of the health and mental health impacts of repeated stress: the effects on motivation, mental ability, sleep patterns and physical health (including diabetes). It includes evidence based information about managing stress to achieve physical and mental well-being. bit.ly/conversation_stress

Healthy eating blog

Hepatitis SA, Adelaide, 2019. Blog post series

These blog posts cover a variety of topics relating to managing a liver-friendly diet including: whether ‘detoxing’ is useful, eating low salt when you don’t cook, low-salt eating at times of celebrations, how to track your sodium intake, how to have a nosalt diet or a low-salt diet, and how to make food preparation easier.

bit.ly/hepsablog_eating

Hepatitis

provides

Postal Address:

Kaurna Country PO Box 782

Kent Town 5071

(08) 8362 8443

1800 437 222

www.hepsa.asn.au

HepSAY Blog: hepsa.asn.au/blog

Library: hepsa.asn.au/library

@HepatitisSA

@hep_sa

Resources: issuu.com/hepccsa

Email: admin@hepatitissa.asn.au

Chair

Arieta Papadelos

Vice Chair

Bill Gaston

Secretary

Sharon Eves

Treasurer

Michael Larkin

Ordinary Members

Lindy Brinkworth

Bernie McGinnes

Janice Scott

Lucy Ralton

Joshua Riessen

Kerry Paterson (CEO)

Hepatitis SA has a wide range of hepatitis B and hepatitis C publications which are distributed free of charge to anyone in South Australia.

To browse our collection and place your orders, go to hepsa.asn.au/orders or scan the QR code below:

Viral Hepatitis Community Nurses

Viral Hepatitis Nurses are nurse consultants who work with patients in the community, general practice or hospital setting. They provide a link between public hospital specialist services and general practice, and give specialised support to general practitioners (GPs) to assist in the management of patients with hepatitis B or hepatitis C. With advanced knowledge and skills in testing, management, and treatment of viral hepatitis, they assist with the management of patients on antiviral medications and work in shared care arrangements with GPs who are experienced in prescribing medications for hepatitis C or accredited to prescribe section 100 medications for hepatitis B. They can be contacted directly by patients or their GPs:

CENTRAL ADELAIDE LOCAL HEALTH NETWORK

Queen Elizabeth Hospital

Phone: 0423 782 415, 0466 851 759 or 0401 717 953

Royal Adelaide Hospital

Phone: 0401 125 361 or (08) 7074 2194

Specialist Treatment Clinics

NORTHERN ADELAIDE LOCAL HEALTH NETWORK

Phone: 0401 717 971 or 0413 285 476

SOUTHERN ADELAIDE LOCAL HEALTH NETWORK

Phone: 0466 777 876 or 0466 777 873

Office: (08) 8204 6324

Subsidised treatment for hepatitis B and C are provided by specialists at the major hospitals. You will need a referral from your GP. However, you can call the hospitals and speak to the nurses to get information about treatment and what you need for your referral.

• Flinders Medical Centre Gastroenterology & Hepatology Unit: call 8204 6324

• Queen Elizabeth Hospital: call 8222 6000 and ask to speak a viral hepatitis nurse

• Royal Adelaide Hospital Viral Hepatitis Unit: call Anton on 0401 125 361

• Lyell McEwin Hospital: call Bin on 0401 717 971

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FREE ONLINE Blood-Safety Education

Update your knowledge about blood-safety and viral hepatitis. Sessions include:

Overview of hepatitis A, B & C

Blood and bodily-fluid safety

Best practice after blood exposure

Stigma and discrimination

Available services