#91 HepSA Community News

#91 • October 2021

Community News

Haemophilia & Hepatitis C Plus World Hepatitis Day and more

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Hepatitis SA provides free information and education on viral hepatitis, and support to people living with viral hepatitis.

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Online: 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 Cover: Red blood cells (erythrocytes) trapped in a mesh of fibrin threads to form a blood clot Correspondence: Please send all correspondence to The Editor at PO Box 782, Kent Town, SA 5071, or email editor@hepatitissa.asn.au.

Editor: James Morrison 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

HEPATITIS SA BOARD Chair Arieta Papadelos Vice Chair Bill Gaston Secretary Sharon Eves Treasurer Michael Larkin Ordinary Members Julio Alejo Catherine Ferguson Bernie McGinnes Sam Raven Kerry Paterson (CEO)

Contents

1 WHD Quiz Winners 2 DAAs in Africa 4 Haemophilia & Hep C 8 Shattered Webinars 10 Overdose Awareness 12 Naloxone 14 In Our Library 16 W hat’s On? / CNP Info 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)

Riverland, Here We Come!

World Hepatitis Day quiz winners

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top B, Cure C Quiz winners, Kylie and Lauren, are looking forward to using their $500 vouchers for holidays with their families.

Kylie plans to take her grandchildren camping one or two at a time. “I love river fishing so Riverland here we come!”

Lauren hopes to use her voucher for a week’s holiday with her partner and dog, in their caravan, once they’ve decided where to go.

Both Lauren and Kylie found the quiz, part of Hepatitis SA’s World Hepatitis Day promotion this year, an interesting and enlightening exercise.

“I found the quiz a useful exercise—it was concise but very informative,” said Lauren.

“Working in healthcare, I am aware of the importance of screening for asymptomatic diseases. However, I was surprised to learn how high the number of people who don’t know they have hepatitis is: 1 in 4 people with hepatitis B and 1 in 5 people with hepatitis C! “As a result of completing this quiz I will be thinking about discussing screening with people more often.”

Kylie said she found the quiz relatively easy although she did go back and reread some of the information to doublecheck her answers.

WIN a $500 Holiday STICKER LOGO

AUSTRALIA’S FAVOURITE LOGO (not to be used on any digital executions)

Stop B. Cure C.

Hepatitis – Don’t Wait.

Do the Quiz and enter the draw to win one of two $500 BIG4 vouchers. hepsa.asn.au/stopbcurec

“I learnt that you could have hepatitis B or C and not be aware of it,” she added.

“Thanks for running the competition.”

Other quiz participants have commented that they hadn’t realised that hepatitis is not included in routine blood tests. “Need to ask my doctor to include hepatitis B and C in my routine blood test, didn’t realize that it’s not included in the routine check,” said one.

Another participant didn’t realise there even was a vaccine for hepatitis B. Besides promotion to the wider community, the Stop B, Cure C Quiz was also the focus of activities with some community groups.

were taken through the quiz information and questions in two separate COVID-safe sessions. Participants entered a paper version of the quiz for an on-the-spot prize draw, as well as being entered into the online competition.

The quiz was actively promoted over two days to the Spire Community Hope’s Café and Op Shop visitors, who were also given the opportunity to enter a paper version of the quiz with a draw for a small gourmet food pack.

We would also like to thank everyone who entered our World Hepatitis Day CNP/ Helpline Promotion (see back cover of last issue). The lucky participants, each winning a gift card were, Fred, Jacinta and John. v

28 July 2021 For your chance to WIN one of 3 $50 prepaid Visa cards, call the HepatItIs sa HelplINe on 1800 437 222 (9am–5pm, Mon–Fri) before the end of July 2021. answer this question correctly: Can people that are currently using illicit drugs access the cure for hep C? leave your name, contact phone number and postcode with the Helpline worker to go into the draw to win.

Winners will be contacted by phone on Friday, 6 August to make the arrangements of how to receive their prize.

anyone can access the cure to hep C if they need it.

Hep C treatment is not recommended during pregnancy or while breast-feeding.

Fifty seniors from the Chinese Welfare Services

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DAAs in Africa

New drugs work against the many HCV strains found across Africa First published at The Conversation (bit.ly/3ngUTO7) Chart courtesy of the Pan African Medical Journal, 2021

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round the world, 71 million people have been infected with the hepatitis C virus. Annually, there are about 400,000 deaths resulting from the effects of infection. If the body fails to naturally clear the virus within a few weeks of initial infection, then it can remain in the liver for decades.

This may gradually lead to cirrhosis or liver cancer. In addition, those carrying the virus are often stigmatised, which may prevent people from coming forward for testing or treatment.

Within the past few years, a new series of drugs called direct-acting antivirals have been developed, which give a much higher rate of curing infection (exceeding 90%).

These drugs only need to be taken orally, and have very few side effects. They also require a relatively short course of treatment for 12 weeks, compared to as long as 48 weeks for interferon-based therapy.

The hepatitis C virus has evolved in different human populations for hundreds or even thousands of years. Over

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time the virus has become extremely genetically diverse.

But the number of strains is limited in high-income countries where the new drugs are in use and known to be effective.

The question we sought to answer in our recent research was whether direct-acting antivirals would be effective in areas where many more strains are found, which are primarily low-income countries. Our findings show that these drugs would indeed be effective against most strains. This information is invaluable to countries with scarce treatment resources.

More effective use of such resources ultimately will save more lives.

Testing new treatments

Our study examined a large cohort of people born in 32 African countries but living in the UK, who were infected with strains of the hepatitis C virus found in their country of birth.

Most of this group had received direct-acting

HEPATITIS SA COMMUNITY NEWS 91 • October 2021

antivirals to treat their infection. So we were able to combine an analysis of the genetic diversity of the hepatitis C virus strains with which they were infected and whether treatment had been successful.

Overall, we showed that direct-acting antivirals were very effective against almost all the hepatitis C virus strains found across Africa.

There were two strains that did not respond well to some treatment combinations.

But re-treating people with a different set of direct-acting antivirals led to successful cure in most cases.

This study is important because low-income countries face numerous challenges with hepatitis C virus infection.

In Africa, more than 10 million people are infected with the virus. Most countries have a limited infrastructure to diagnose infection, treat those who are infected and confirm that treatment has been successful. In addition, the cost of direct-acting

antivirals places an economic burden on many countries.

Therefore, it is important to catalogue all possible diverse strains of the virus and determine whether they respond to direct-acting antivirals treatment. The main problem with hepatitis C virus diversity is that some strains can have natural resistance to treatment.

Since confirming successful treatment of infection is an added burden for lowincome countries, it is crucial that the most appropriate direct-acting antivirals combinations are used in settings where potentially resistant strains may circulate.

Improving treatment in Africa

Our study shows that more potent direct-acting antiviral drugs would work successfully in countries where numerous different strains are found, including those with strains that are resistant to some of the less potent direct-acting antivirals combinations.

Hence our study feeds into the information needed to select the best suite of drugs for curing hepatitis C in low-income environments. Moreover, since the World Health Organisation has mandated the global elimination of hepatitis C by 2030, our

study contributes to that goal by confirming the crucial role that directacting antivirals will play. v John McLauchlan Professor of Viral Hepatitis, University of Glasgow

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Haemophilia & Hepatitis C My hepatitis cure

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avin Finkelstein is the president of Haemophilia Foundation Western Australia.

He has lived with haemophilia for his whole life, and with hepatitis C since childhood.

For World Hepatitis Day, he was kind enough to tell us his story of living with coinfection and how he was cured of hepatitis C.

Until at least 1995, people in Australia with haemophilia and related bleeding disorders were totally reliant on blood products for all of our treatment.

In my case I was born in 1962 and when I was young I was

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treated with bottles of whole blood that were infused (each over a 12-hour period) to resolve bleeds. This would happen anywhere between 10 and 50 times a year. This means I was probably infected with the hepatitis C virus (HCV) before I was 5 years old, and then reinfected perhaps hundreds of times over the

but they were still blood products. For example, we went from whole blood to blood plasma-based products, which were in smaller volumes for treatment, and which didn’t require extended hospital stays. I would be injected with the blood plasma product (called cryoprecipitate) and then go

years. Although HCV has existed in humans for perhaps thousands of years, it was not properly identified until 1989, so there was no way to identify it in the blood of a donor.

home. I no longer had to be an “in-patient”, waiting for the bottles of blood to empty into me over a 12-hour period.

Over the years our treatment products were refined,

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Another later innovation was plasma-derived clotting factor concentrate: each

batch of concentrate was made up of about 10,000 donations pooled together, so the risk for HCV infection by a bloodborne virus was significantly high—if even one of those donors had hepatitis C, it would end up in the pooled mix.

Haemophiliacs were often considered to be “the canaries in the mineshaft” if there was a blood-borne virus infecting recipients of blood products. This was shown in the early 1980s, when large numbers of the haemophilia community were infected with HIV because of our total reliance on blood products:

before there was an HIV test, the poorly understood virus had made its way into the donated supply.

After this, our treatment products were heat-treated to destroy the HIV virus. I was fortunate to miss out on HIV, but I was told in 1990 that I had what was then called “non-A, non-B hepatitis”, which we now know as hepatitis C. “Don’t worry about it,” I was told. “There is nothing we can do about it anyway!” Heat treatment of blood products to inactivate HCV was introduced very early in the 1990s, but by then it was too late for a vast

number of our community’s members.

In early 1994 I was properly diagnosed with hepatitis C and it had a profound effect on me. I didn’t know if I was going to live! Was there treatment? What was going to happen to me? There was so little information available. I became depressed, I ended the relationship I was in (I didn’t want my girlfriend to see me get sicker and die), I wasn’t working, and I became withdrawn, convinced that this was the end.

It wasn’t until 2001 that I undertook combination therapy—first Interferon/

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Illustration by Freepik

October 2021 • HEPATITIS SA COMMUNITY NEWS 91

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haven’t been addressed or carried out, which has unfortunately resulted in a variety of serious impacts to members of the bleeding disorders community over the 17 years since.

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ribavirin therapy, and then Peg-Interferon/ribavirin— which consisted of over 200 injections of interferon and over 2,000 ribavirin pills over what ended up being an 18-month period. This was when combination therapy, as difficult as it was, was the best hope of being cured of HCV. I continued to work during this whole treatment period, often getting asked when arriving at work if I had taken my “grumpy” pills. I experienced all the side-effects, and it felt that my brain was just barely ticking over. It cost me promotions at work, I often made mistakes, and I had to be managed during the whole treatment process.

All of my work colleagues and bosses knew and had received letters advising of the possible consequences of the treatment, but it still

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was a monumental effort to work the whole time. And in addition, I was volunteering with Haemophilia Foundation WA (HFWA) and Haemophilia Foundation Australia (HFA).

Each evening and weekend I used to collapse, each weekday morning I would drag myself begrudgingly out of bed to attend work.

I completed treatment in 2003, clearing HCV—and then I relapsed 6 weeks later, which was utterly devastating. I decided against trying treatment again for a few years, and ended up waiting and hoping that newer, better treatments might become available.

In 2004 I was part of the HFA team that presented at the Commonwealth Inquiry into Hepatitis C and Blood Supply in Australia, a landmark inquiry whose recommendations still

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In 2005 I decided it was time to retire due to the impact of HCV (I was suffering from constant tiredness, a lack of motivation, a foggy head, and feeling generally burnt out) and the physical impacts of haemophilia (I was due for my second knee replacement and I was experiencing chronic arthritis in my ankles, elbows and knees).

But in the same year I became president of HFA, which is a voluntary position, and which has been an amazing and rewarding experience.

I’ve developed new skills, seen advances in treatments for bleeding disorders and HCV, met amazing people worldwide, and I hope, been able to represent my community in a way that has been of benefit to all.

In 2007 I decided to take the plunge again and try treatment once more with Peg-Interferon/ribavirin.

After 12 weeks, sadly, I wasn’t PCR-negative, which meant the treatment wasn’t working, so I discontinued it.

I continued to monitor and follow treatment

changes and advancements, bypassing triple therapy (which used Peg-Interferon/ ribavirin and a direct-acting antiviral agent) because of the horrendous side-effects experienced by everyone I spoke to about it, and because it only had a 40-60% of a successful outcome.

In 2016, when the new generation of direct-acting antiviral medications targeting HCV were approved for use on the Pharmaceutical Benefits Scheme (PBS), I started treatment as soon as it could be organised. After completing the 16 weeks of treatment, which was now just a single tablet a day with no side-effects, I was cured of the hepatitis C which I had been living with for a least 35 years. The fog finally lifted, and I felt great!

Of course, while it was fantastic to be cured of HCV, I still had to deal with the ongoing lifelong consequences of haemophilia: deteriorating joints, chronic arthritis and accelerated ageing. People living with both bleeding disorders and HCV deal with an overload of chronic health conditions, and it can be hard to prioritise your care and manage your health, especially when hepatitis symptoms like fatigue and brain fog

compound your health problems and sap your energy.

Having access to a simple HCV treatment with minimal sideeffects was genuinely great for us.

Nearly all members of the bleeding disorders community in Australia have now been cured of hepatitis C, which is an amazing achievement, but some still live with ongoing issues connected with liver cancer or cirrhosis. Often they need to retire early, which brings with it financial stress and the possibility of spending decades of your life in and out of hospital wards. Having

cleared one hurdle, I can focus more on managing my haemophilia. As there is no cure for haemophilia, this is a lifelong task. But it is a much easier one without the added burden of hepatitis C. If there is anyone out there still living with haemophilia and HCV who hasn’t been in contact with us or the Haemophilia Treatment Centre clinicians, please know that there are no impediments to treatment now; there are just the fantastic results that we have all experienced. It is certainly very worthwhile. v

Diagram showing the damage done to a knee joint by repeated internal bleeding in the joint

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International students shattering myths for international students

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n early 2020, Hepatitis SA was approached by two Adelaide University students, Apoorva Kulkarni and Siddhartha Guha. They were seeking volunteer placements with Hepatitis SA, and they joined the Information and Resources team, looking at which of our resources could be useful if translated into Hindi, their first language.

In March 2020, however, the initial COVID lockdown meant that all volunteer opportunities had to be suspended.

Fortunately, Apoorva and Siddhartha kept in touch with Hepatitis SA, and in late 2020 they contacted us to discuss other options for working together, which evolved into developing a webinar series for Indian students at Adelaide University.

In the end, a 4-webinar series was created, taking place in April and May this year. The series was titled Shattered!, and looked at four topics: • Hepatitis C and Body Art • Hepatitis B, vaccination and COVID • Drugs and harm reduction

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• ‘Living Book’ Kath Leane, who talked about her lived experienced with hepatitis (see issuu.com/hepccsa/ docs/hcn87) Each webinar utilised the ‘Polls’ feature on Zoom to engage the participants.

Participating students were able to select the correct answers at the end of the education session, and feedback from the students throughout the webinars was very positive. We talked with Apoorva and Siddhartha about their experience volunteering with Hepatitis SA and running the seminars.

What made you interested in focusing on hepatitis in the first place?

Siddhartha: Studying public health has taught me that health promotion works as a preventative measure against various diseases. I had read about Hepatitis SA in a newsletter, and had also heard about the sister organisations in other states. I had been looking to brush up my skills in health promotion and also to connect with a community that I had joined only recently.

Hepatitis SA works with

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various CALD groups, and this really caught my attention— working with CALD and other vulnerable populations is something close to my heart and something that I am really passionate about.

Apoorva: I was looking for volunteer work in something that would be related to the field that I was pursuing (public health), and I thought Hepatitis SA would be a good starting point to gain some exposure in the health promotion area. I heard about Hepatitis SA through a few friends who were a part of Hepatitis Victoria, and I thought I would express my interest.

And what made you decide on the form your project took, a webinar series?

Apoorva: We wanted something that would be within our scope while volunteering with Hepatitis SA and international students were the audience that we could reach out to. We thought understanding of hepatitis and related informationon laws and regulations around basic things like recreational drug use, vaccinations, and so

on, would be something that students would be interested in—especially if we provided incentives like prizes! This idea got us excited and we approached Hepatitis SA.

series, as it was the safest and most responsible thing for us to do.

Siddhartha: When we first started with Hepatitis SA, we were in the process of reviewing resources that would be appropriate for doctors from a clinical perspective (as I myself am a dentist). But due to COVID this had to stop. Upon reconnecting with the organisation, we wanted to do something for the community that would be useful and aimed towards the International student cohort, as we had more reach there and were part of that community.

COVID meant we had to do it on Zoom as a webinar

Apoorva: It would have been nice if this was something that could be done in-person, as it would have been more interactive. Also, promoting the webinar series was quite difficult because everything was online and gaining an audience other than our friends was pretty difficult!

What were the difficulties in doing this under COVIDrestricted conditions?

Siddhartha: Yes, getting the word out without physically meeting people and getting them to join in. There were also many technical difficulties as well which were out of our control. A face-to-face seminar may have had a better response from the public as well, which cannot always be guaranteed online. Making the sessions interactive without being physically present or showing demonstrations which otherwise would have been done in a face-to-face condition can be a challenge.

How do you think the Shattered! series was received? What sort of feedback did you get?

Siddhartha: People received the series in a positive manner and were really happy and intrigued by the information they received. Hopefully we can run this series again and focus on other groups in the community.

Apoorva: The feedback was quite good—we did get a lot of people telling us that it was informative and interesting.

We’d like to thank Apoorva and Siddhartha for all their hard work and look forward to working with them again . v

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International Overdose Awareness Day E

very year there is an increase in the number of Australians who lose their lives to accidental drug overdose, with countless Australians experiencing the grief caused by the loss of loved ones. The most recent available overdose data reveals that in 2019 there were 1,644 unintentional overdose deaths in Australia (See the Penington Institute’s Australia’s Annual Overdose Report 2021).

International Overdose Awareness Day (IOAD), held annually on 31st August, is a day to raise awareness of overdose, reduce the stigma of drug-related death and remember those who have lost their lives to overdose.

IOAD community events provide an opportunity for services to promote overdose prevention and response, including how to administer naloxone in the event of opioid overdose (see p12 for more on naloxone).

IOAD originated in Australia, in 2001, with NSP workers at the St Kilda Salvation Army needle and syringe program (NSP) distributing ribbons and providing information to raise awareness of the risk of overdose. The day is now a global event recognised in over 40 countries. The colours of IOAD are silver and purple: wearing a silver ribbon pin raises awareness of overdose and wearing anything purple is a way to show that anyone can be affected by overdose.

This year at Uniting Communities U City, where the Franklin St Clean Needle Program (CNP) is located, we planned a number of features to increase awareness and for clients to express memories for those lost to them from overdose.

Hepatitis SA CNP Project Officer Margie speaking about overdose from a personal experience perspective at the Aboriginal Community Connect IOAD barbecue, August 2021

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Overdose Awareness extended beyond the U City CNP into the building’s first-floor administration area. We created a display consisting of resources, posters, badges, CPR mask keyrings, take-home naloxone vouchers and other information. All of Uniting Communities’ visitors and staff were able to learn about IOAD. Information on opioid, stimulant and psychoactive

Our IOAD information and giveaways display at Uniting Communities Adelaide

drugs was included in the display. Clients could help themselves to these as well as the silver—silver represents everyone being important— OD pins, badges made with a badge machine loaned from Bfriend, and other items, and they could ask Hepatitis SA peer educators for more information.

We also placed a Memory Tree, to which handwritten notes could be attached, in the general waiting area. Clients expressed appreciation and gratitude for the chance to acknowledge the loss of loved ones, mates and relatives through writing on decorative note paper that was then pinned onto the Memory Tree.

Clients were so happy to be able to express their loss—to have this loss recognised by others—and the tree filled with coloured notes. v Carol Holly & Penni Moore A community member writing a tribute to a loved one to hang on the Remembrance Tree at this year’s Uniting Communities Adelaide event.

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Keep Calm and Carry Naloxone

Saving lives simply

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aloxone is a life-saving medication that can reverse an opiate/opioid overdose by blocking the effects of an opioid drug or medication (such as heroin, methadone, morphine, codeine, etc). Naloxone is safe to use, non-addictive and has no active effect other than to reverse opioid overdose. Administering naloxone can keep a person alive and breathing until the ambulance arrives.

Naloxone is a short-acting medication so it is vital to call an ambulance and continue to monitor the overdosed person. It is important to use naloxone in addition to calling an ambulance, not instead of calling an ambulance!

There are a number of circumstances that can be considered risk factors for opioid overdose. These

include: not having used opiates/opioids for a while (for example after prison, detox, or drug-free treatment), mixing opioids with other central nervous system depressants such as alcohol or benzodiazepines, using (injecting or smoking) alone or in an unfamiliar environment, and accessing opioids from a new or unfamiliar source (or if a regular source or supply has changed or their product is stronger than usual).

Prior to 2016, naloxone was a PBS schedule-4 medication, which meant that it could only be provided on prescription by a medical practitioner. Anyone who wanted to access naloxone, in order to have it on hand to use in the case of witnessing an overdose, had to ask a GP for a prescription. It took a very brave and very determined person to stand up to the judgement and discrimination of their GP and ask for a naloxone prescription.

In February 2016, naloxone became available over the counter at pharmacies. It was still available from medical practitioners as an S4 medication but it was now also available as an S3 medication that could be

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HEPATITIS SA COMMUNITY NEWS 91 • October 2021

supplied by a pharmacist without a prescription.

This was great news as it meant that people could purchase naloxone directly from a pharmacy without needing to see a GP. The aim was to make naloxone more accessible. The drawback was that the over-the-counter price of naloxone ranged from $40 to $60.

In December 2019, SA commenced participation in the Australian Government Take Home Naloxone (THN) Pilot. Under the pilot, naloxone became available for free from participating pharmacies. Initially the pilot was to continue until February 2021. The pilot was extended until June 2021 and has now been extended for a further 12 months until June 2022.

The Take Home Naloxone Pilot is a great initiative and is not restricted to people who inject drugs or people who use drugs illicitly. Many deaths involving opiate/ opioid use are a result of accidentally taking too much prescribed opioid medication.

Vouchers to exchange for free naloxone can be obtained from hospitals, primary care settings, alcohol and other drug (AOD) services and,

most importantly, from Clean Needle Programs (CNPs).

Vouchers are available at all Hepatitis SA fixed and sessional site CNPs and can be presented at any participating pharmacy.

Hepatitis SA Peer Educators provide a brief intervention with each voucher to ensure that the person accessing the naloxone has information on preventing and responding to overdose, including how to administer naloxone.

Naloxone is available as ampoules for intramuscular injection and as an intranasal spray. The intranasal spray is a good option for people who are not comfortable or confident using needles and is a quick way to administer naloxone without needing to deal with needles, syringes and ampoules. Only a squirt of the spray up one nostril is required (the plunger must be depressed all the way).

sometimes have to return at another time to collect it.

People who use drugs may feel uncomfortable asking the pharmacist for naloxone because of past experiences of discrimination. It would be preferable to provide naloxone through the CNP rather than providing vouchers. There would be more naloxone available in the community, which equates to more lives saved.

Some states in Australia are

already providing naloxone directly through needle and syringe programs and druguser peer programs. We hope SA will soon join the list of states providing naloxone directly from Alcohol and Other Drug services and NSPs (called Clean Needle Programs or CNPs in SA).

For more information on the Take Home Naloxone Pilot go to health.gov.au/initiativesand-programs/take-homenaloxone-pilot. v Carol Holly

There is no limit to the number of times an individual can access vouchers or exchange vouchers for naloxone.

You can’t knock free naloxone but there are still barriers to accessing it through the THN pilot. Pharmacies don’t always have the naloxone in stock, so people may

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Self-management

Useful tools to improve your quality of life

If you’ve been diagnosed with liver disease (or know someone who has) the news can be overwhelming. But there are some really great resources available to step you through understanding the possible impacts on your life, and how to deal with them in a positive way.

The following publications, videos, apps and websites offer information for, and by, people who are affected by liver disease. They include general information about your liver, how to stay healthy, how to organise health appointments, and some personal insights into living with a health issue.

These resources, and more, are also available via our online catalogue – click on the green ‘search our catalogue’ link at the top of the library home page (hepatitissa. asn.au/library) and click on ‘Browse topics’ > ‘Australian Community Resources’.

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The LiverWELL app LiverWELL (Hepatitis Victoria), Melbourne, 2021. Online App. liverwell.org.au/get-the-app Free phone app designed to • create reminders for medications • schedule your upcoming medical appointments • add your test results • keep your liver health notes all in one place • deliver up-to-date information about liver health news • provide links to selfmanagement guides on eating, drinking, exercise and feeling well.

Available in Arabic, Burmese, Simplified Chinese, English, Thai and Vietnamese.

HepSAY (blog) Hepatitis SA. Adelaide.

Webpages. hepatitissa.asn.au/blog Hepatitis and liver health news and views from SA including healthy living tips, specific dietary advice, transmission information, treatment and testing updates, services available, personal stories etc.

HEPATITIS SA COMMUNITY NEWS 91 • October 2021

Liver smart Hepatitis Queensland, Brisbane 2021. 1 min. Video plus webpage hepqld.asn.au/liver-smart Anyone can get liver disease and most people do not know they have it. This short video lists the risk factors and the simple lifestyle behaviours that can reduce the risk of serious liver disease. The webpage includes links to further information and directories.

Share your story (blog) Hepatitis Australia, Canberra.

Webpages. bit.ly/3zcRQsz A selection of personal stories from people in Australia who have been affected by hepatitis B or hepatitis C. They discuss the challenges they have faced, what they have learned on their journey and, for some, the joy of being cured of hepatitis C.

Healthy living guide for the Aboriginal community.

Helping you care for your liver and your mob Hepatitis Victoria, Melbourne, 2020. 12p. bit.ly/3lrsvq1 Information about: eating well, getting active, feeling well, being drink aware and helping you to care for yourself and your mob. With links to more resources for each of these issues.

A guide to hepatitis B: testing, treatment and staying healthy Hepatitis Australia, Canberra, 2020. 1: 50 min video; 8p. booklet bit.ly/3CiC812 To help understand the process (and results) of being tested for hepatitis B to living well with chronic (life-long) HBV. Designed to help people who are at risk of, or have been recently diagnosed with HBV. Available in Chinese, English, Italian, Khmer and Vietnamese.

Mindfully Aust Broadcasting Corporation, Sydney, 2020. 5 sound files ab.co/3kgAsyQ Sydney Swans legend Brett Kirk teams up with the experts in Mindfulness, Smiling Mind, to show you how you can use mindfulness in different areas of your life, to find a calmer and happier you. Focusing on relaxation in the time of COVID-19

Living with advanced liver disease Hepatitis SA, Adelaide, 2013.

22p. bit.ly/3En67a4 Helpful hints about eating difficulties, low/no salt foods, managing symptoms (itchy skin, confusion etc.), dealing with emotions, and some contacts for transport and support services. NB: some services may not be available due to COVID restriction and/ or other changes.

Love Your Liver: Nyuntumpa alu wiru kanyinma Hepatitis SA & Aboriginal Health Council of SA, Adelaide, 2014. 16p bit.ly/3lsCqLZ A bi-lingual (Pitjantjatjara and English) step by step guide on hepatitis B and liver health: what HBV is, how it is (and isn’t) transmitted, treatment, how to live well with it, how it may affect pregnancy, and who you may have to tell.

Read-only online, or contact us for hard copies.

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WestCare Services: 11/19

195000; COVID-SA E TO DU Millers Ct, Adelaide R 415 FO call on ED 0423 782 THE NE DMargery AN make an ST appointment ANCING, AL DI SOtoCI CLINIC • AL Wonggangga L LIVERTurtpandi Aboriginal Primary Health HAVE SESSIONS Care Service (Pt Adelaide SPENDED EN1stSU BE CNP); Wednesday of each L FURTHE month, amR , 11 UNTI9.30–11.30 ChurchNO St, Port Adelaide SA : TICE 5015

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e Pleas Anglicare Elizabeth Mission; 7 22 18001443 17 April, Aug, 132Nov, 9.30am –12 pmpa , 91-93 titisElizabeth he for Way Elizabeth (Bookings via information reception in person, or call 8209 5400) Noarlunga GP Plus; fortnightly, Alexander Kelly Dr, Noarlunga Centre SA 5168 (Bookings via Noarlunga CNP

A Note to Our CNP Clients We are approaching the COVID-19 pandemic with an abundance of caution in line with the recommendations of health experts.

We ask that you arrange for someone else to collect your equipment, if you have • any flu-like symptoms such as fever and cough, or

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• We will place equipment on a table for you to pick up: this will maintain social distancing • We will fill out the data sheet

• We recommend that you collect a month’s supply of equipment (in case of any upcoming closures or supply delays)

• recently returned from travel overseas.

• If you can ring ahead, please do so in case any further changes have taken place.

When collecting equipment, we ask that you cooperate with ‘social distancing’ recommendations:

These measures are for YOUR safety as well as ours. Please respect the CNP workers so we can keep this service going!

HEPATITIS SA COMMUNITY NEWS 91 • October 2021

Useful Services & Contacts Hepatitis SA Free education sessions, printed information, telephone information and support, referrals, clean needle program and library.

(08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au Hepatitis SA Helpline 1800 437 222 (cost of a local call) Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card.

Call Hepatitis SA on 1800 437 222 for a referral. beyondblue Mental health information line

Hutt St Centre Showers, laundry facilities, visiting health professionals, recreation activities, education and training, legal aid and assistance services provided to the homeless.

Nunkuwarrin Yunti An Aboriginal-controlled, citybased health service, which also runs a clean needle program.

258 Hutt St, Adelaide SA 5000 (08) 8418 2500

PEACE Multicultural Services HIV and hepatitis education and support for people from nonEnglish speaking backgrounds.

Lifeline National, 24-hour telephone counselling service.

13 11 14 (cost of a local call) www.lifeline.org.au Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers.

13 14 65

1300 224 636 www.beyondblue.org.au

MOSAIC Counselling Service For anyone whose life is affected by hepatitis and/or HIV.

Clean Needle Programs in SA For locations visit the Hepatitis SA Hackney office or call the Alcohol and Drug Information Service.

(08) 8223 4566

1300 131 340 Community Access & Services SA Alcohol and drug education; clean needle program for the Vietnamese and other communities.

(08) 8447 8821 headspace Mental health issues are common.

Find information, support and help at your local headspace centre 1800 650 890 www.headspace.org.au

(08) 8406 1600

(08) 8245 8100 Sex Industry Network Promotes the health, rights and wellbeing of sex workers.

(08) 8351 7626 SAMESH South Australia Mobilisation + Empowerment for Sexual Health www.samesh.org.au Youth Health Service Free, confidential health service for youth aged 12 to 25.

Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100

Viral Hepatitis Community Nurses Care and assistance, education, streamlined referrals, patient support, work-up for HCV treatment, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for an appointment.

Central: Jeff - 0423 782 415 margery.milner@sa.gov.au

Debbie - 0401 717 953

North: Bin - 0401 717 971 bin.chen@sa.gov.au

Michelle - 0413 285 476

South: Rosalie - 0466 777 876 rosalie.altus@sa.gov.au

Specialist Treatment Clinics 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 or 8222 2081 • Lyell McEwin Hospital: call Michelle on 0413 285 476 or Bin on 0401 717 971

hepsa.asn.au

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HEPATITIS SA COMMUNITY NEWS 91 • October 2021