Good Liver March 2017 edition by Hepatitis Victoria

The Magazine of Hepatitis Victoria

March 2017

Good Liver

Reflecting on the future

Q&A with the Minister for Health

Stigma and discrimination

Celebrating 12 months of hepatitis C cure. There is still so much to do, but what an advantage we have in unrestricted access to treatment.

Hepatitis Victoria asks Minister for Health, Jill Hennessy about the encouraging uptake of new treatments in Victoria.

Hepatitis Victoria believes it is possible to eliminate stigmatising and discriminating attitudes and behaviours towards viral hepatitis.

Staff Contact and postal address:

Hepatitis Victoria Suite 5, 200 Sydney Road, Brunswick, Victoria 3056. Telephone: (03) 9380 4644 Facsimile: (03) 9380 4688 Email: admin@hepvic.org.au Website: www.hepvic.org.au

HepatitisInfoline

1800 703 003 Melanie Eagle CEO

Telephone: 9385 9102 melanie@hepvic.org.au

Garry Irving

Programs and Operations Manager Telephone: 9385 9109 garryi@hepvic.org.au

Martin Forrest

Health Promotion Program Manager Telephone: 9385 9111 martin@hepvic.org.au

Damian Salt

Office Coordinator Telephone: 9380 4644 admin@hepvic.org.au

Aurora Tang

Community Education and Engagement Manager Telephone: 9385 9103 aurora@hepvic.org.au

Contents Carolyn Mogharbel

Health Promotion Officer Telephone: 9385 9112 carolyn@hepvic.org.au

Shwetha Shankar

Health Promotion Officer Telephone: 9385 9108 shwetha@hepvic.org.au

Dolly Hoang

Health Promotion Officer Telephone: 9385 9105 dolly@hepvic.org.au

Sione Crawford

Health Promotion Officer Telephone: 9385 9110 sione@hepvic.org.au

Dina Abdelsalam

Hepatitis C CALD Outreach Officer Telephone: 9385 9105 dina@hepvic.org.au

Kaz Cochrane

Development Coordinator Telephone: 9385 9118 kaz@hepvic.org.au

Lien Tran

Hepatitis B Community Education Project Officer Telephone: 9385 9123 lien@hepvic.org.au

Digital and Online Services Officer Telephone: 9385 9106 shaun@hepvic.org.au

Communiqué

From the desk of the Chief Executive Officer

Reece Lamshed

De-livering the news

News, reports and papers

6 8

Treatment in custody

Karen Greening

One year of a hepatitis C cure in Australia.

Nicole Gunn

Shaun Knott

HEPReady Business Development Manager Telephone: 9385 9116 reece@hepvic.org.au HEPReady Project Officer Telephone: 9385 9117 karen@hepvic.org.au HEPReady Sales and Client Liaison Officer Telephone: 9385 9119 nicole@hepvic.org.au

Kate Sievert

Community Participation Officer Telephone: 9385 9114 kate@hepvic.org.au

Kaspian Fitzpatrick

Stigma Response Co-ordinator Telephone: 9385 9113 kaspian@hepvic.org.au

Jawid Sayed

Hepatitis B Community Education Project Officer Telephone: 9385 9121 jawid@hepvic.org.au

Tuan Nguyen

Reflecting on the future

10 Q&A with the Minister for Health Jill Hennessy.

12 Where are they now? 15 Stigma and discrimination

You can help Hepatitis Victoria make things better.

Thoughts from the Infoline and frequently asked questions post treatment

18 20 21 22 23

Meet our new Hep Heroes

Make sure you’re HepReady Talking about HepSpeak Here’s to your good health Interview with Peter Revill

Pursuing a cure for hep B.

Contacts and Liver Clinics list

Hepatitis B Community Education Project Officer Telephone: 9385 9105 tuan@hepvic.org.au

Lara Kanaef

Hepatitis B Community Education Project Officer Telephone: 9385 9104 lara@hepvic.org.au Hepatitis Victoria would like to thank HepHero Stephen Taylor for allowing us to use his wonderful drawings which appear on pageas 8, 9, 16 and 17.

Good Liver is produced by Hepatitis Victoria, with support from the Victorian Government. The opinions and language expressed in this magazine are not necessarily those of Hepatitis Victoria or the Department of Health and Human Services.

Reader response Your comments or experiences in regard to any articles in Good Liver are welcome. Email: admin@hepvic.org.au

Graphic Design: Swivel Design 0435 733 206

Communique

From the desk of the Chief Executive Officer now be free of hepatitis C, but are still living with the very real prospect of developing liver cirrhosis, if not liver cancer, unless they seek treatment for their condition. At Hepatitis Victoria we are concerned that many people are simply unaware they are living with the condition. We are also concerned that others may be aware of their hepatitis C status, but have no idea that they are able to access the new, non-invasive treatments, which have a greater than 95% cure rate.

his issue of Good Liver is a celebration of our collective journey, highlighting the fact that we have come a long way in the last 12 months since the new miracle treatments for hepatitis C became widely available in Australia. It also a timely reminder of the ongoing work that needs to be done if we are going to achieve the ultimate goal of eliminating hepatitis C. Since 1 March 2016, around 15% of people living with the deadly virus have accessed treatment – which is great news.

We have to continue to push two very important messages: 1. If you have ever (even if only once) shared injecting equipment, SEE YOUR DOCTOR AND GET TESTED FOR HEPATITIS C. 2. If you have previously been diagnosed with hepatitis C, see your GP and arrange to get treated. Even if you are symptom free, there is no point waiting to ‘get hit by the bus’, when such highly successfully treatments are available now. We need to increase treatment rates for people as yet undiagnosed, those unaware of treatment availability, and

marginalised people, including prisoners, indigenous Australians, and people who inject drugs. To achieve elimination we have to accompany this with increased efforts in prevention and stopping reinfection. This includes access to clean and safe injecting equipment and facilities. We also have to increase the emphasis on building the capacity of the community and health workforce so they can join us in the efforts towards elimination. This is in relation to hepatitis B as well as hepatitis C. Not only will this ensure that people currently living with hepatitis are encouraged and equipped to access treatment, it will help to prevent new infections of hepatitis. Of course, this issue is not all about hepatitis C. There are some very exciting developments on the horizon for hepatitis B, as detailed in our story on page 23. As Jane Little observes in her article on page 13, “We all deserve to live life well!”

Yet it also shows the huge number of people around 200,000 - who should

De-Livering the news Some frequently asked questions

New treatments and infographic New treatments are continuing to be rolled out â&#x20AC;&#x201C; the most recent is Zepatier, for use in genotypes 1 and 4. (See infographic above).

Inquiry into Drug Law Reform The Victorian state government is conducting a Parliamentary Inquiry into Drug Law Reform to consider: 1. the effectiveness of laws, procedures and regulations relating to illicit and synthetic drugs, and the misuse of prescription medication in minimising drug related health, social and economic harm; and, 2. the practice of other Australian states and territories and overseas jurisdictions, and their approach to drug law reform and how other positive reforms could be adopted into Victorian law. In its submission to the Inquiry, Hepatitis Victoria has recommended increased access to needle and syringe programs in the community

Syringe vending machine provide 24-hour access to safe injecting equipment. Hepatitis Victoria is also calling for needle and syringe programs to be introduced in prisons and other custodial settings in order to reduce the spread of blood borne viruses. Finally, Hepatitis Victoria has confirmed its support for a pilot of a medically supervised injecting centre, not only to save lives by preventing overdoses, but also to reduce the risk of transmission of hepatitis through access to clean equipment and

across Victoria. This includes an extension of the current program

provision of accompanying education.

through appropriately located syringe vending machines which

The Inquiry is expected to release its findings in March 2018.

Little HepB Heroes update As you will recall, the Little HepB Heroes crowdfunding campaign kicked off in December last year. In addition to our fundraising efforts, we have taken a number of important steps to help us realise our Little HepB Heroes dream:

• Our working group met in January and additional community

consultation meetings were carried out in February to develop the storyboard for the Little HepB Heroes book.

• A proud working group with dads, mums and daughters from

different cultural backgrounds - Australia, Vietnam, China, Cambodia, Romania, Somalia - has been formed. They met recently, to develop their personal “mission” statements for the project.

How will the crowdfunding help? Your financial support will enable us to:

• Translate the book into more languages. Our community advisors are very keen to ensure that this resource is available in the wide range of languages spoken among the priority communities (as outlined in the National and Victorian hepatitis B strategies).

• Produce more books and videos to provide to our target communities.

• Expand our reach to communities in need, including providing more education sessions to help ease the family difficulties in talking about the condition impacting their own lives.

We have not reached our target yet and hope you will help us get there by spreading the word. If you haven’t yet had a chance to donate to our crowdfunding campaign, but would like to, click on the QR code here, or visit our web page: https://chuffed.org/project/littlehepbhero

Could Murray Bridge be the first to eliminate hep C?

In the coming months we will be progressing:

• An exciting kids’ art competition for the development of the Little HepB Hero character – the kids definitely have to be able to identify their own heroes!

• Work with a professional writer and illustrators to have the book and animation ready for production and translation into Chinese and Vietnamese.

• Distribution of the book/video to the community in education sessions

Murray Bridge, SA at sunset Murray Bridge in South Australia is hosting a national pilot project this month that could make it the first city in the world to eliminate hepatitis C. Despite an unprecedented number of Australians being cured of the disease in the past year, treatment uptake has proven slower in rural and regional areas. Hepatitis SA will work with the town’s community to trial a wholecommunity approach to raise awareness about liver health and increase testing and treatment of hepatitis C.

Crowdfunding

Local doctors, sporting clubs and services will collaborate to offer testing to the community and education around symptoms of the disease and how it is spread. Original article appeared in The Murray Standard: http://www.murrayvalleystandard.com.au/story/4463377/murraybridge-leads-global-fight-against-hepatitis-c/

Treatment in custody A new app designed to help with managing liver health In December 2015, when the Australian Federal Government announced the decision to fund access to the new highly effective Hepatitis C Virus (HCV) treatments, they also made a commitment to working with state governments to ensure that the new treatments were available to prisoners nationwide. The Victorian Statewide Hepatitis Program (SHP) is an initiative funded by Justice Health, the Department of Justice and Regulation, Victoria, and delivered by St Vincent’s Hospital (Melbourne) Gastroenterology Department. It is part of that commitment made by the Victorian Government to improve the health and wellbeing of everyone affected by chronic viral hepatitis. In Victoria, of more than 6,000 prisoners it is estimated that up to 40% have a seroprevalence for HCV. Prisoners are one of the most high-risk and complex populations living with chronic viral hepatitis. They are especially vulnerable to the serious health consequences of untreated liver disease. Prior to 2015 a view existed that the key barriers to accessing prison-based treatment

The New treatment has been a “Life Changer” for me and I’m sure for thousands more too!

regimens included: primarily the severity of side effects and how these would be managed within a custodial environment, the need to engage significant resources from tertiary hospitals, and a treatment length that often exceeded the length of someone’s sentence. These barriers have now been largely eliminated now with the availability of the new direct-acting antiviral (DAA) therapy for HCV. Along with a program to deliver effective care to prisoners, there is a very real opportunity now to break the cycle of HCV and reduce the burden of viral hepatitis in prisons.

achieved by implementing a HCV and HBV

With the support of Corrections Victoria and the Justice Health-sponsored SHP, the aims of SHP are to deliver best practice clinical care and also to improve health outcomes for prisoners living with chronic HCV infection and chronic HBV infection. This is being

The SHP commenced in July 2015 with

My health improvements continued over the 3 months of treatment. After a diagnostic blood test – yes, believe it or not, I was CURED!! The Hep C Virus was no longer in my body.

program service delivery model that provides a comprehensive evidence-based model of care for prisoners in all Victorian Prisons. The program delivers statewide, decentralised care for prisoners through a protocol-driven, structured assessment and management of antiviral therapy service delivery model, delivered by two full-time Clinical Nurse Consultants (CNCs) who visit each prison, in person, every two to four weeks. The CNCs are supported by two parttime gastroenterologists. SHP assessment clinics commencing in October 2015. Since the commencement of the assessment clinics 1,032 prisoners have been assessed. The HCV treatment program commenced on 1 March 2016,

I was given the opportunity to have treatment for my Hep C. I had no side effects. I would like to thank all involved and hope one day everyone will be free of this virus.

and as of February 2017, 590 prisoners have commenced treatment . To date feedback received from prisoners, where a positive outcome has been experienced, has been that of relief that they can now be rid of this disease, which for many has been a burden for years. One prisoner reported about his treatment: “Fantastic! I felt like I had been cured of a cancer that I had for 30 years or more”.

After only 1 week I started to feel really good – which I didn’t expect. What a monumental decision to make this treatment available to everyone.

There is almost a degree of ‘disbelief’ that

edited to remove reference to people and or

the treatments could be as simple as just

location of a prisoner.

“taking a tablet” as many prisoners have seen first-hand the effects of the Interferon-based therapies on friends and fellow prisoners. The SHP CNCs as well as the nursing staff caring for prisoners’ onsite all over the state have received many other comments about individual treatment experiences, including: The statements (below) which have been

Society owes a lot to our decision makers! Because not only have thousands of people been cured and continue to be treated, also they been neutralising thousands more off the ‘knock on effect’ of infected people passing it onto others – NO MORE!

L. McDonald and A. Craigie, St Vincent’s Hospital References: 1 National Prison Entrants’. Bloodborne virus and risk.

Behaviour survey report. 2013. The Kirby Institute

2 Data source: St Vincent’s Hospital (Melbourne)

Gastroenterology Department.

…. I received a message that the treatment had worked and that my reading was not detected anymore. I was so relieved and so bloody happy…clear and free from the virus ….this treatment pretty much saved my life or at least has given me an extra 30 years thanks to having a healthy liver.

Reflecting on the future

One year of a hepatitis C cure in Australia.

n March 2016 Direct-Acting Antivirals (DAAs) with a cure rate over 95% were made available on the Pharmacuetical Benefits Scheme (PBS) for everyone with hepatitis C over 18 with a Medicare card. With this, the community of people living with hepatitis C in Australia started down a path that has already transformed our present and our personal futures, and has the potential to lead to a place not many of us would have thought possible a few years ago: to a nation largely free of hep C.

Others have stopped on the street and begun

A year into this journey, how are we doing?

A common question that is coming through

A great start for some of us

the Hepatitis Victoria Infoline now is whether

More than 13,000 people in Australia were started on the new hep C treatments in the three months following their introduction . So, if you were in touch with a specialist or had been awaiting the impending availability of DAAs in March of 2016 it’s quite possible you are free of hep C right now! This is fantastic. It is difficult to convey just what it means to be clear of something which for a long time had no real prospect of cure.

crying when they realise what it actually means to be clear of hep C after so many years. Others feel a crisis of identity as this state which they have identified so strongly with for 20, 30 or 40 years is suddenly changed. For some of these people the shame, guilt and secretive handling of this part of themselves for so long was debilitating and to rearrange how one feels about that might take some time.

we will remain antibody positive following treatment. For some this is still a mark of stigma and potential mark of shame and discrimination. Even if you want hep C to be in your past, it isn’t that simple!

For a long time people using and injecting drugs were unable to access treatment. It will take some time both to undo the reputational damage this did regarding the treatment community, and to undo the belief that current injectors, users and drinkers are still barred from treatment. We know many current injectors and users who have breezed through treatment and this community are critical to engage with, both because we must address hep C in current users to eliminate it, and because everyone deserves treatment. Unfortunately that old beast stigma and discrimination raises its head particularly with this community. We have spoken to GPs who firmly believe injecting is a contraindication to hep C treatment because, in their view, that person must be unstable if they are using. On the other hand we have spoken to people who inject drugs who see treatment as something they don’t yet deserve. Users have said to us that they believe the money (the cost of treatment) would be better spent on someone who isn’t using drugs, and that treatment should be like a prize for people who are have stopped. This self-stigmatisation can be heart-breaking.

Stigma and discrimination still persists And this is important to remember: we can’t treat away stigma and discrimination! As a For at least the first six months of the new treatments, between 80% and 90% of new DAA initiates were over 40 . Most of those over 40 with hep C would likely have become positive at a time when there was no effective treatment and when it was considered a lifelong disease. Twenty-five years ago it wasn’t really known how it would impact people in the long term or what mortality was likely. We have been told multiple stories here at Hepatitis Victoria by community members about the unexpectedly strong emotions that clearing hep C brought on. People whose partners had died from liver disease but who had themselves now cleared hep C are understandably conflicted: “what a wonderful opportunity for me but so disappointed it came too late for the one person I have ever loved.”

society we still have to come to grips with our attitudes to hepatitis C and injecting drug use in particular. While many have been treated there is still so much to be done. There is reluctance amongst some of us for a range of reasons and there are still enormous barriers to treatment for most people. Echoes of treatments past still linger and inform many people. The devastation that was interferon treatment for many in the community still impacts on people’s decisions. We have spoken to folks who are still affected by earlier (often ineffective) interferon treatment six to ten years later, and who are understandably afraid of side effects – “even if most people don’t have serious side effects, what if I’m in the small percentage that do?”

Quite apart from the fact health care should not be based on subjective notions of who is deserving - there is simply not a zero sum game when it comes to hep C treatment in Australia. Fortunately, treating one person for hep C does not take that opportunity away from another person. Unfortunately stigma and discrimination is not usually about logic and reason but emotion and fear. Breaking down the selfstigmatisation of those who feel they are not worth treatment, and the discrimination many health care professionals still exhibit

may be a long process but we absolutely must get on with that if we are to treat everyone with hepatitis C. Engaging and prioritising the voices of people who inject who have completed treatment - not just in peer education but in advocacy with service providers - is one way forward.

Innovation in service provision Another, complementary way forward is the re-orientation of services that work with marginalised populations to ensure there are effective pathways to treatment for their clients. For example, Hepatitis Victoria has worked with services that are doing new things in areas such as homeless support and community health to ensure as many people as possible are given the opportunity to enter treatment.

Testing and diagnosis Another part of the puzzle is related to stigma but also to education and awareness raising. It is estimated that some 15% of people with chronic hepatitis C in Australia are not aware of it. Not addressing this alone has the capacity to scuttle any attempt at elimination. There are multiple reasons for this gap in diagnosis. Not least among them is the shamefully high proportion of people who have had a discriminatory encounter with a health care worker, and who have had negative experiences with diagnosis. These stories carry through the affected community and they echo for years, just as the fear of interferon based treatment has. It is expecting a lot for these to be broken down in 12 monthsparticularly as discrimination continues. People with a recent history of injecting drugs are rightly the priority for education and awareness raising about prevention and treatment of hep C, and should remain a focus if we are seeking to eliminate hep C. There are also other populations which we can consider,

for example people who no longer inject drugs, who may not recognise their exposure risk and may have undiagnosed hepatitis C. This is likely a small population but will require a different strategy to engage.

Prevention and prison As well as different communication strategies for different populations a range of solutions will be needed alongside treatment to eliminate hep C. Not least of these is continuing and expanding prevention efforts. While treatment may provide effective prevention in the very long term, we have effective blood-borne virus transmission prevention strategies in place right now. These need to be expanded and made available more widely to ensure people who inject can do so as safely as possible both before and after treatment. Prisoners with whom Hepatitis Victoria works care about their health, and many more have access to testing and treatment now as well. While we need to take this part of society along with us on this journey we also need to give all people the same tools equally to take care of their health and prevent hepatitis transmission. Currently people in prison donâ&#x20AC;&#x2122;t have that equivalent access to sterile needles and syringes, despite clear evidence that it is possible to undertake it safely. This issue alone threatens the progress we are making in treatment.

While the rates of GP initiated treatments are rising it is also true that a regular query on our Infoline is how to contact a GP who is not discriminatory and who is willing to prescribe new hep C treatments. Too many callers have been knocked back by their own GP or do not have one. Without a comprehensive and publicly available list it is not easy to put people in touch with a provider in their area. This is just one such structural barrier to widening treatment. Others include confusion about chemists and GP uncertainty about the process of work-up. The good news is that

solutions are steadily being implemented. The fact remains, however, that even if we have treated around 30,000 people so far, and even if that is more than have ever been treated in our history, it leaves 85-90% of hep C positive people yet to be treated, 15% of whom do not know they have hep C and many are in communities medicine has traditionally struggled to be accessible to. There is a lot of work to do, but it is good to keep in mind just what an advantage we have in unrestricted access to treatment. Very few other countries have that base to work from and we must take advantage of this.

Sione Crawford Hepatitis Victoria Health Promotion Officer

Going forwards It is year one in what is a 15 â&#x20AC;&#x201C; 20 year plan to eliminate hepatitis C. We are collecting some data as a sector but we are still at a stage where any prediction on where we will end up is speculation. From tapping into community experiences and the data on treatment which is being collected, it appears as though a solid start has been made with an older population in touch with specialist services.

References: 1 Kirby Institute Newsletter: Monitoring Hepatitis C

Treatment Uptake in Australia No. 6, Feb 2017 2 Kirby Institute Newsletter: Monitoring Hepatitis C

Treatment Uptake in Australia No. 6, Feb 2017

Q&A with the Minister for Health Jill Hennessy.

A roadblock to the new treatments uptake is that people are unaware of just how easily accessible these new treatments are from their local GP. Hepatitis Victoria: For hepatitis B, what do you see the biggest road blocks to eradicating the public health burden of disease by 2030? JH: If people engage in regular chronic disease management for the condition with their GP or specialist, they can live long, healthy and productive lives. But, for some time now we have been aware that long-term untreated hepatitis B is one of the main risk factors for liver cancer. Getting more people vaccinated, tested, diagnosed and managed is critical to reducing hepatitis B-related mortality. Hepatitis Victoria: What do you see as being the biggest road blocks to achieving the elimination of hepatitis C by 2030? JH: We have a very real opportunity to make hepatitis C a thing of the past. The new treatments available are incredible, so if we can treat enough people, reduce transmission, and improve the lives of countless Victorians then our targets are very achievable. The barrier to this is awareness of the new treatments. We are doing everything we can to promote the new treatments, but there are still some people that are unaware of just how accessible these new treatments are and how easily accessed from their local GP. There’s work to do to create awareness across the board, both consumer and health professional, to ensure the treatment is understood and administered correctly. We mustn’t overlook the stigma and discrimination that people with hepatitis C face. Incorrect judgement and assumptions are often a major road block and something we must turn-around so that people feel comfortable talking about their needs and seeking treatments.

For some time now we have been aware that long-term untreated hepatitis B is one of the main risk factors for liver cancer. Hepatitis Victoria: What do you think are the big positives that will assist us in achieving our elimination goal? JH: There have been some very exciting developments for hepatitis B and C in recent years that make these goals a reality. For hepatitis B, we can now train general practitioners in primary health to treat the virus, which makes treatment more accessible than ever before. The Victorian HIV and Hepatitis Integrated Training and Learning Program, run by a consortium led by the North Western Melbourne Primary Health Network and launched this year, will see unprecedented numbers of general practitioners trained to treat hepatitis B – a fantastic achievement that will see real change at a local level.

In 2016 the Andrews Labor Government expanded the rollout of the free hepatitis B vaccine to include Aboriginal Victorians, in addition to the other priority populations who were already eligible. This means more people than ever before are protected from hepatitis B. I welcome the universal listing of the new hepatitis C treatments because it means all people living with the virus can have their lives transformed by living free of hepatitis C. Never before have we had treatments that are so easy to tolerate, so easy to prescribe and, available through general practitioners in local health settings.

The rollout of free hepatitis B vaccine to include Aboriginal Victorians means more people than ever before are protected from hepatitis B. Hepatitis Victoria: What are the imperative actions needed to raise the broader community’s awareness of viral hepatitis? JH: We must continue to raise awareness in priority communities around prevention and treatment for hepatitis B and C. Hepatitis Victoria, a range of other community organisations, and the Department of Health and Human Services have been working very hard to get the message out about viral hepatitis prevention, treatment and care.

We must continue to raise awareness in priority communities around prevention and treatment and we must focus on eradicating stigma and discrimination

We must focus our efforts to eradicate the debilitating impacts of stigma and discrimination, as we know they can directly affect people’s capacity to engage in prevention, treatment and care.

of doctors being trained in viral hepatitis, and more prevention-focussed initiatives. This has enabled more Victorians to be treated for hepatitis C within a year than were ever before in the history of the virus.

Hepatitis Victoria: What does the public health sector need, or need to do, to be best equipped to facilitate the elimination target

Hepatitis Victoria: Australia is leading the way on availability of new hep C treatments by making it available to everyone living with hepatitis C, including people who inject drugs, and people without liver disease. How important do you think the approach is to the eradication of the disease?

Hepatitis Victoria: At what points does the service system need to collaborate to make it easier for people to access treatment and management services?

communities and among health providers and shift perceptions. Key to achieving this will be working in partnership with affected communities and with the different parts of the health system to develop patientcentred services.

JH: The Victorian Government believes in equity and fairness – that all people regardless of their background are entitled to the same high quality healthcare. By not imposing restrictions on people who use drugs, we can make sure that all Victorians can benefit from what these treatments offer.

Hepatitis Victoria: What do you feel have been the greatest achievements in the past nine months since the hepatitis B and hepatitis C strategies were launched? JH: I am very proud of the strategies because they reflect our commitment to providing the best healthcare possible for all Victorians. Since their launch, the strategies have been an important tool in shaping directions for the viral hepatitis sector. This includes driving investment to Hepatitis Victoria, the Victorian Aboriginal Community Controlled Health Organisation, the Primary Health Networks and immunisation services. This investment is leading to increased community campaigning and awareness, high numbers

Investment is leading to increased community campaigning and awareness, high numbers of doctors being trained in viral hepatitis, and more preventionfocussed initiatives

JH: In Victoria we have a strong, and long tradition of collaboration. This is very important because if we don’t collaborate it will be impossible to meet our goals of eliminating the public health burden of viral hepatitis. A key point of collaboration is across the community sector. People with, or at risk of, viral hepatitis represent every cultural, social and economic group. Rather than this being a challenge, I think it’s a wonderful opportunity. By supporting local services that people are already using, such as multicultural health, youth, aged care or mental health, we can provide person centred programs that are richer because they address a person’s wider needs.

By supporting local services that people are already using, such as multicultural health, youth, aged care or mental health, we can provide person centred programs that addresses a person’s wider needs. People who do not have complex cases of hepatitis B or C should be treated by their general practitioner. But, we recognise that links to specialist care are essential for some people who have more complex needs, and because we want doctors to feel clinically safe should they need decision making support. We need to ensure models of care are anchored in primary health care, local to where people live, but with clear pathways to specialists, if that is needed.

JH: We need to raise awareness in

It also means developing tailored messaging for the different people and communities affected by viral hepatitis. This is definitely a challenge because we know that there are varying levels of individual health literacy and community awareness.

We need to: Raise awareness in communities and among health providers Develop tailored messages for people and the communities affected by viral hepatitis. Hepatitis Victoria: Does the government have interim targets – say at the five or 10-year mark? JH: The Victorian hepatitis B and C strategies have set very bold targets for 2030 for the reduction of transmission and viral hepatitis-related stigma and discrimination, and for increases in testing and treatment. Indeed, these targets exceed those set by the World Health Organization, and Australia’s national strategies. The Victorian Departmental Advisory Committee on Blood Borne Viruses and Sexually Transmissible Infections is currently developing indicators to measure our progress. These indicators will be drawn from current research, and from various surveillance systems funded by the Department.

Where are they now?

A year on from starting the New Treatments.

Billy Abbott A year on! January 16th 2016. I finished my hep C meds and was given the all clear...no fxxxg sign of any virus in my system and my ALT reading of 18. The first time in over 30years my body and moreover my liver is free of this virus...hurrrah! Now a year down the track and the most notable difference is I have more energy, I don’t have as fat a gut and I don’t have episodes of depression! I’m working a physical job and have a view to living for while longer. Had a lot of great feedback re the posters on the tram stops... onward and upward...

Joel Murray

Julie Shiels

The pill regime was pretty straight-forward. I

Thirty-three years ago, just before my fortieth

took one pill a day for 12 weeks each morning

birthday, I found out that I had hepatitis C.

with my other HIV meds. I had very few side

I was shocked at the time. It was an era of

effects – maybe a few headaches and a bit of

new and frightening diseases. HIV/AIDS had

‘fuzzy brain’ around week four that cleared up around week five.

been identified in 1983; Hep C in 1989. People were scared because, suddenly, blood

At the end of the treatment I felt good and had

was dangerous.

discovered a sense of whole-body lightness.

Unsurprisingly, there was a lot of

I was pretty sure that I had cleared the virus finally, and 12 weeks after treatment a blood test confirmed it had worked! Now I’m hep C free, I’ve still got to be careful about risks because I am not immune. I’m speaking publicly to try and encourage other people living with hep C to seek out treatment. I guess the good news is that if I do end up getting hep C again, (because let’s face it, we sometimes make mistakes), I can access treatment again immediately. To read Joel’s story in full visit: http://livingpositivevictoria.org.au/ wp-content/uploads/2017/02/Poslink_ Issue_077.pdf

misinformation, and fear and discrimination, swirling around. There was little information available about the disease – it was pretty terrifying. In spite of this, looking back on those 33 years, I’d have to say I’ve been one of the lucky ones. I lived relatively symptom free. I’ve been fortunate that my family, friends and coworkers have treated me well. But at times I felt alone and uncertain about what the future would hold. So I had no hesitation when the new medications became available in March 2016 to book in with my doctor, and start treatment. I completed my treatment course over 12 weeks. I finished treatment in October, and confirmed that I had cleared the virus. Life is great, and I am excited about what the short and long term future holds for me, and my family.

I didn’t find out about my hepatitis C status until 2010. It was extremely confronting and I was very upset and angry as I had transformed my life and given up drinking and taking drugs in 1984 and felt after living a sober life for 25 years plus, it was very hard to accept. After dealing with the confronting news of my diagnosis I also found out my daughter had to be tested. This was because I had given birth to her in 1986 when I was living with hepatitis C and could have passed it on to her at birth. That was the longest two weeks of my life,

Jane Little

waiting for her blood test results. Luckily she was one of the lucky 95% who did not contract the virus from their mother.

I am living free of hep C. I am a 63-year old mother of two (and grandmother of two) and after more than 30 years of living with Hepatitis C am now cured of the virus. I cleared Hepatitis C after a 12-week treatment regime on a drug called Harvoni, which was one of the four drugs listed on the

Raising community awareness and eliminating hepatitis C There are still 200,0000 people living with hepatitis C, with the very real prospect of cirrhosis, liver cancer, liver failure and possibly death and or the need of a liver transplant.

2016 to treat Hepatitis C.

There are multiple reasons why many people haven’t come forward: for some it’s because

In the nearly 12 months since these drugs

but for many I think they are simply not aware

Pharmaceutical Benefits Scheme on 1 March

became widely available, only 35,000 of the 230,000 people infected with hepatitis C have come forward for ‘the cure’. I desperately want to try to change that statistic by personally raising public awareness of these life-saving drugs and helping to meet the 2030 target of eliminating Hepatitis C. I probably contracted hepatitis C in the late 1970s or early 1980s when I was a bit of a WILD CHILD and dabbled in intravenous drug use. Or I may have contracted it through other medical situations, as there was no blood screening before 1989. HOW I contracted the virus is irrelevant but HOW I got rid of it is incredibly important. The new “miracle” drugs have a greater than 95% cure rate and minimal side effects with a 12-week treatment duration. Unlike the previous dual therapy of 48 weeks, which was very gruelling both physically and mentally, with only a 50% cure rate and in some cases, extreme side effects.

they aren’t aware of their hepatitis C status,

need to get the virus back again. They can look forward to renewed energy and hopefully, when and if they are ready, may be able to use that energy to transform their lives and also become drug free. I’m living proof that not only people can change and be free from substance abuse, but that people can be cured of viral hepatitis. I feel I’ve had two second chances at life and want others to have that second chance. If you ‘ever’ injected drugs please be tested for hepatitis c because there is a real chance that you could be living with this silent killer. But the key thing to know here is that there is now a cure!! I would urge everyone who feels they are at risk to go to their GP, ask for the antibodies test for hepatitis C. If they do have a positive diagnosis, then have the other necessary tests and get onto the treatment as soon as possible. Reach out to the medical fraternity, most of whom are amazing, also to their family and friends and wider community to get the support they need. Since clearing the virus I have a renewed energy and hope for the future. I can be present and full of energy and totally ‘there’

For those in our community who are still struggling with addiction – they have to know they can be free of viral hepatitis and if they practice safe injecting procedures don’t ever need to get the virus back again of the availability of new, non-invasive, highly successful treatments, which are vastly different to the earlier gruelling treatment regimes.

to love and support my beautiful children and grandchildren and use this renewed energy to help others living with this debilitating virus.

personally affected by these negative and

My hope is that others – living with, or living with someone with hepatitis C - will help to raise awareness of the new treatments and reach out to the hundreds of thousands in our community still afraid or unaware of being able to come forward for this life changingcure, and to ultimately achieve the elimination of hepatitis C in Australia.

upsetting attitudes many times.

We all deserve to LIVE LIFE WELL!!!

Also in our society there is still strong stigma and discrimination (sadly both in the medical profession and general community) against people who used to use drugs, which may also be preventing people from coming forward. I know, because I have been

For those in our community who are still struggling with addiction – they have to know they can be free of viral hepatitis and if they practice safe injecting procedures don’t ever

Continued over page

Where are they now?

Damian Salt I was diagnosed with hep C five years ago. I knew the why, the when and the how that led to me making poor choices that resulted in a positive diagnosis. Fifteen years earlier I had absolutely no idea when I went to get some blood results after a short stay in a psych unit and was told I was HIV positive. I was devastated, confused and spent the good part of five years accessing medical records to prove that it was a misdiagnosis. In retrospect it was a waste of time and I needed to accept it. But it was the hardest thing to swallow in my life up to that point. I was engaged and committed to understanding the virus and I will always be thankful to my GP who has been with me since day one. Two days after I was exposed, I visited my doctor and stated I have hep C. He assured me that a couple of tests may prove otherwise and to remain positive. Tests were done and I had it confirmed, I was now co-infected with HIV and hep C. Proactively, I walked from that appointment to Hepatitis Victoria with the aim to learn first-hand how this virus was going to affect me. By volunteering and participating in any way I could, it was the perfect place to gain perspective on what was ahead of me. Specialist appointments gave me the lowdown on the treatments available back

then with a warning that they were not for me due to a fragile mental disposition. But there was talk that new medications were becoming available, that were interferon free and worth waiting for. The time frame was all a bit vague. So I decided I would wait three years and if these new treatments were not available, however bad the current treatment was, I would give it a go.

Letâ&#x20AC;&#x2122;s talk about side effects. The first three

and I now gift the same pill box in support of

Parliamentary Inquiries, letter writing and political lobbying ensued.

appointment and followed up in January with

weeks of treatment saw me becoming lethargic and tired in the middle of the day. By end of week three this feeling had gone, I had a little trouble remembering to take the medication due to the lack of any side effect, and I missed several doses until my colleagues presented me with a pill box. I am forever grateful to receive this kind of support a person taking up treatment. I had follow up appointments at week four, eight and 12. By week eight I had cleared the virus. I completed the 12 week treatment and my three month test after treatment was scheduled for December 21. I missed that bloods and a fibroscan. With the slight delay

Forward to March 1, 2016 and the announcement of the new DAAs being available in Australia on the Pharmaceutical Benefits Scheme (PBS). Success!

I received a call from my GP on February 15.

So it is fitting that in this March 2017 issue of Good Liver I can take you through my treatment journey.

that a monkey has been lifted off my back. I

Damian, he said, you have officially cleared the hepatitis C virus. I am asked if I feel different. I certainly feel feel lighter and happier and I am compelled to speak about the treatment journey very loudly.

The possibility of these new treatments was gaining momentum and I threw myself into the Hepatitis Victoria Community Advocates group and together we lobbied whoever we could in order to get our message heard. I was diagnosed with genotype 3. I had my first appointment three months after the PBS announcement that also required a fibroscan. The results proved all good to go. I was prescribed Sofosbuvir and Declastivir, two tablets once a day for 12 weeks. My GP took the opportunity to change my HIV meds at the same time as I had been taking them for 20 years. Script in hand, I visited my pharmacist with whom I have developed a relationship with over the years for consistency. I highly recommend cultivating these relationships and have found these professionals appreciate your loyalty and are actively engaged with your treatment.

For too long hepatitis C has been victim to discrimination, misconceptions and downright ignorance and misinformation. I pledge to change these attitudes at every opportunity I can, and if people turn away, I WILL FOLLOW THEM.

Stigma and discrimination

Barbecued salmon with fennel, orangemake and chickpeas You can help Hepatitis Victoria things better!

Stigma and discrimination have a significant impact on people’s health and wellbeing

epatitis Victoria has a vision of a Victorian community where there are no new infections of viral hepatitis and where those with hepatitis maximise their health and wellbeing. Hepatitis Victoria believes that it is impossible to achieve this vision, where stigmatising and discriminating attitudes and behaviours are enacted towards people with viral hepatitis. Personal accounts and research show that experiences of stigma and discrimination have a significant impact on people’s health and wellbeing, potentially affecting multiple areas of a person’s life. Stigma and discrimination in regards to viral hepatitis (both B and C) can affect not only how a person feels within themselves, but also challenge or prevent individuals from accessing social support, health services, schools and workplaces, and financial security. Hepatitis Victoria is committed to responding to issues of stigma and discrimination. The first step in this response is to listen to the experiences of people who are affected by hepatitis B and/or hepatitis C, and to develop more thorough ways to record these experiences. We want to know what the most pressing issues are for people with viral hepatitis, in regards to experiences of stigma and discrimination, and the most effective ways to respond to these issues. We will investigate the range of options people have to address experiences of discrimination through already existing channels such as reporting to the Equal Opportunity and Human Rights Commission.

We will look at how people affected by viral hepatitis feel about using these available channels, and whether there are ways we could support people in accessing these options to greater effect. We will also investigate opportunities for additional or alternative ways of responding to stigma and discrimination issues.

Co-ordinator, to talk to him about your thoughts on the matter. He would be excited to hear from you. Over the coming months we will be running focus groups to learn more about people’s experiences to ensure we capture the wide range of opinions. If you are interested in this kind of consultation, please get in contact with Kaspian. We also want to hear from you if you work with an organisation that has an interest or insight into this subject or is keen to explore potential collaborations in this area.

So, if you are living with viral hepatitis, we want to hear from you! One way you can participate is by filling out a survey on the Hepatitis Victoria website (www.hepvic.org.au). It is anonymous and the information provided will be treated with the strictest of confidence. Go to: www.hepvic.org.au/page/1219/ have-your-say to find it! You are also welcome to get in contact with Kaspian, Hepatitis Victoria’s Stigma Response

Kaspian can be contacted on (03) 9385 9113. If you, or someone you know, would find a translator useful to this call, please call 131 450 first and quote customer code C619321 to arrange one and then they will call Hepatitis Victoria. Alternatively email Kaspian on kaspian@hepvic.org.au. He works on Monday, Tuesday and Friday. If he doesn’t answer please be sure to leave a message and he will get back to you.

Kaspian Fitzpatrick Hepatitis Victoria Stigma Response Co-ordinator

Thoughts from the Infoline

and frequently asked questions post treatment

he Hepatitis InfoLine, managed by Hepatitis Victoria’s health promotion team and the community engagement and education they deliver to “at risk” groups has allowed us to develop an understanding of the impact of the new hepatitis C treatments, and the range of related issues and concerns.

Some of the key issues confronting our communities are:

I’ve finished treatment – can I drink alcohol again? Hepatitis C treatment with Direct Acting Antivirals isn’t affected negatively by drinking so whether or not we can drink alcohol safely is not related directly to whether or not we have completed treatment! Having said that many people choose to abstain from alcohol while undergoing treatment to give themselves the best opportunity to succeed.

• Anxiety and apprehension about the • Navigating through the health system

small rural communities where choices may be limited).

• Clarifying information that has been provided via other online sources.

• Privacy and disclosure issues post

treatment completion (eg. insurance products and the definition of a pre-existing condition; disclosure to health workers where chronic infection is no longer present but fibrosis or cirrhosis remain).

We all need to play a role in ensuring that the number of people accessing the new medicines is sustained. Stigma and discrimination has a significant impact on our ability to achieve elimination and the best way to overcome this is to ensure that people are well informed and that myths and misinformation are challenged.

The issues we need to take into account regarding drinking are:

• The level of damage (inflammation,

scarring or fibrosis) that has already occurred in the liver.

• The history of or likelihood of problematic

and binge drinking.

• The quantities of alcohol being taken. It is best to discuss this with your specialist or GP – we can’t give individualised medical advice. Alcohol in moderate amounts does not have to damage your liver if it has little scarring. On the other hand if you have cirrhosis, any amount of alcohol puts your liver under pressure and is probably not advisable.

Following is an overview of some of the more common questions we have received on the topic of post-treatment issues.

The general rule of thumb is to keep your alcohol intake at or below the low risk guidelines:

Martin Forrest

• No more than two standard drinks a day over

Hepatitis Victoria Health Promotion Programs Manager

your lifetime, or no more than four standard drinks in one session.

• Don’t forget that most glasses in pubs and most drinks containers contain more than a standard drink. The number of standard drinks contained in pre-packaged alcohol should be on the label.

The last word: avoid alcohol if your liver is damaged, and avoid drinking beyond the guidelines at any time. If you have had drinking issues in the past please think twice before drinking again!

Yes. It is possible to get hepatitis C again after clearing it. It is possible to get the same strain (genotype) you had and it’s possible to get different strains as well.

(especially is a concern for people from

and friends their treatment journey.

content. For instance drinking four rum and cola’s not only includes alcohol but high sugar levels which can also put stress on the liver and in the long term lead to NonAlcoholic Fatty Liver Disease.

Can I become reinfected with hepatitis C after clearing it?

new treatments.

• Guidance on how to explain to family

• Finally – be aware also of mixers and sugar

There is no immunity to hepatitis C and no vaccination. Treatment and clearance doesn’t confer immunity to any strain of hepatitis C. On the other hand your blood will not carry the virus so you can’t pass it on unless you get reinfected. It’s always worth acting as though everyone has a blood borne virus and taking appropriate precautions to ensure there is no blood to blood contact. The antibody to hepatitis C will persist in your bloodstream after treatment but this is not the virus. If you have an antibody test in the future it will be positive but that does not mean you have the virus. To assess this you must have a PCR test. If you are still using drugs and injecting then it is obviously really important to use sterile equipment both for yourself and anyone else you use with.

If I have hepatitis B/hepatitis C co-infection, are there any issues I should be aware of after finishing the hepatitis C treatment and clearing hepatitis C? While it is great news that you’ve cleared your hepatitis C, you need to continue all the usual precautions to take care of your hepatitis B. If the hepatitis C has been “dominant” your hepatitis B may assert itself more strongly than it has previously and it is really important that

you continue seeing your specialist regularly to monitor your hepatitis B. It may be that you will need to alter or begin treatment for hepatitis B. Unfortunately hepatitis B does not have a cure at present, but we do have highly effective medications to assist in managing the virus. Of course you will also need to continue with the usual precautions against transmitting the virus as well, including using condoms during sex, not sharing injecting equipment and not sharing household equipment which has any chance of spreading blood or sexual body fluids.

When will I start feeling better again? Like when will I stop being tired? The unsatisfactory answer for this is that this is different for everyone! Some people have reported feeling better halfway through their treatment and others have reported still being tired many weeks after treatment has ended. The answer really depends on exactly what is causing fatigue. While we will often attribute negative health issues to our hepatitis C; in fact ageing, diet and lifestyle all play a part in issues like fatigue.

Firstly, it’s important to continue taking good care of the liver with the usual precautions of eating a low fat and low sugar diet; limiting alcohol intake and getting good exercise regularly.

Once you have cleared the virus through treatment (or spontaneously!) there is no point in ever getting an antibody screening test again, as antibodies will always show up and therefore always be positive.

Secondly, re-treatment may be an option. In some cases people may be offered treatment with the same medications, but for a longer period than the usual 12 weeks. i.e. for up to 24 weeks.

The ongoing test that you need to undertake is the PCR (Polymerase Chain Reaction) test, which tests for virus presence, not just antibodies.

Another possibility, although less likely, is that of clinical trials or compassionate access to new treatments in the pipeline. This would need to be discussed with your treating specialist, like any of these options. Treatment is never a “failure” although it can be so disappointing and even devastating to not have cleared the virus. Benefits can include a decreased viral load and simply feeling better, despite not clearing the virus completely. In Australia we are not restricted to one attempt by the funding bodies and this means that we do not have to give up hope if the first attempt does not work!

I’ve just done 12 weeks with the new DAA meds. What if I haven’t cleared the virus? The most important blood test for checking you’ve cleared hepatitis C is at 12 weeks after your last DAA med or pill. This is testing for “Sustained Virological Response” – commonly called SVR - and is measuring whether the virus has been cleared from your system completely. If the virus is not clear at this point the treatment has not been successful. There are a few options available to you at this time, but of course these should be discussed with your GP or specialist.

It’s more common than people might think. We have had many calls from people who feel like this after completing treatment. After all, this is something that most of us have carried with us and thought about, taken into consideration and worked around for many years. Up to 40 years for some of us! That is bound to work its way into our personality and the way we interact with the world and how we see ourselves. It doesn’t mean we would rather have hepatitis C than not, but it does mean that it can be tricky to adjust to seeing ourselves without hepatitis C. If you’ve been carrying it as a secret then it can be frustrating not being able to jump up and down and tell the world that you’ve cleared it! It’s such a wonderful and freeing feeling and yet some of us can’t even share it with our best friends!

We have definitely had people engage with us who, since completing treatment, no longer need an afternoon nap and who find it easier to maintain their energy levels. The best way to combat fatigue in the long term is to eat healthily, exercise regularly and put as little stress on our livers as possible!

I feel like I’ve lost a part of what makes me who I am now I don’t have hep C. Is this common or am I being weird?

Can I donate blood now I’m cured? No. While the virus has cleared and you cannot transmit the virus anymore your blood will still carry the antibodies that your body has produced to fight off the virus and these will show up in any screen that the blood bank undertakes. They will dispose of the blood so there is no point donating.

Will I always carry antibodies to hepatitis C?

It’s hard to “give advice” about something like this because we are all so different. But what is important to remember and know – whether you have cleared the virus or not – hepatitis C does not have to define us. We aren’t good or bad people if we have or haven’t got hepatitis C! It’s our actions and the way we work in the world that defines that! If you have any comments or questions about the topics above or about pre-treatment or issues during treatment please write in or email us at info@hepvic.org.au or call us on 1800 703 003. We’d love to hear from you!

Yes. But this does not equal carrying the virus. The antibodies are produced by the body to fight the virus but are not the virus itself.

Meet our new Hep Heroes

Rotha Prum

In Victoria, chronic hepatitis B infection prevalence among those being born in Cambodian stands at the fourth highest burden. I

AM A HEP HERO because I believe that everyone can contribute to improving the health of people with hepatitis regardless of oneâ&#x20AC;&#x2122;s

profession, and it starts with us. I am an international student from Cambodia, in the last semester of my Master of Public Health at the University of Melbourne. With my 10-year experience as a nurse in a childrenâ&#x20AC;&#x2122;s hospital and public health work in World Vision Cambodia organisation, I have volunteered for Hepatitis Victoria since early July 2016 by supporting and contributing to prevention and education programs within the Cambodian communities across Victoria. I was born in Cambodia where hepatitis prevalence is very high, yet the disease is not widely mentioned within local communities.

Without realizing their hepatitis B status, these people can pass the disease to their descendants unintentionally especially for those from high hepatitis B prevalence countries like Cambodia. In Victoria, chronic hepatitis B infection prevalence among those being born in Cambodia stands at the fourth highest burden.

Although 95% of adults with hepatic B infection can get cured naturally, many of them do not know their infection status. The bigger concern is that the transmission from mothers to babies can make a 70-90% chance of developing into chronic infection with hepatitis.

Although I started working as a health professional worker, the disease was still a rare topic to put in common discussions.

Nonetheless, volunteering with Hepatitis Victoria has opened a gateway for me to have more of an understanding of the burden of hepatitis in Australia as well as globally, which urges me to spend my spare time off university studies to join with the organisation in raising awareness about the virus. It was my great opportunity to learn from elderly Australian citizens originally from Cambodia that they need more information and support on hepatitis. Thus not only people in Cambodia like me, but also the immigrants from the country have heard a little information about hepatitis, a silent blood-borne virus that often show symptoms much later after infected.

With the accurate information about hepatitis, people can make the right decision on time, since hepatitis C now is curable and hepatitis B treatment is even more effective. This also helps the community to have a broad view of social stigma by seeing hepatitis as a preventable and eradicable disease. In the role of Hep Hero with Hepatitis Victoria, I believe that I can contribute to make this happen.

Rothaâ&#x20AC;&#x2122;s message to others: Knowing your hepatitis status today gives you a golden chance to take care of yourself and your family as a whole.

Gorden Luong

Not only is hepatitis C now curable, but there are many facilities out there, that can provide the support needed to overcome and prevent the virus. I

AM A HEP HERO because I believe that through persisting with education and a proper understanding of one another, our

community, as a whole can prevent and eventually eradicate all possible forms of viral infections. I hope that by becoming a Hep Hero and offering my perspective on hepatitis, I can contribute to the understanding of the struggle against the elimination of the social stigma that comes with viral hepatitis. Currently I am a university student with a Chinese/Vietnamese

This is why I had decided to spend my spare time off university studies to raise awareness about the virus with the organisation, in the hope that one day people could be as health conscious about hepatitis as they are about responsible drinking and smoking. Since then I have never viewed the word “hepatitis” in the same way. Hepatitis is a silent blood-borne virus that transmissible from personto-person through contact with the blood and often people do not know they’re infected until much later.

3rd year of Biomedicine & Commerce at Monash University.

The damage done to their liver by the virus could already be so severe and irreparable to the point that not only their quality of life drops, but also those around them. In the worst case, through the suffering, the patient also could be branded by those closest to them, maybe avoided, even scorned.

Before I came into contact with Hepatitis Victoria, hepatitis was but a

All this, solely caused by a virus that shows no symptoms.

small word which was rarely mentioned within the family - almost as if

But don’t forget that through the many years a particular patient has lived with the virus, how many more have been infected in that time? It’s not a very pleasant thought.

background. I am part of a second generation of migrants from overseas. Upon registration as a HEPHero, I will have spent a good year assisting Hepatitis Victoria in their work and will be finishing my

it were a taboo to speak of it. Only when there was a medical urgency or when the family welcomed a new member of the family did I hear the word, as part of a discussion between differing professions of medical practitioners. Other than that, I’ve had very little exposure of the word itself, and hence knew almost nothing of it right up until I came across Hepatitis Victoria. Upon reading a number of information pamphlets from the organisation, I had come to realise the severity of the virus. Not only that, but it was such a common occurrence and yet… I have barely heard anything about it prior to meeting with Hepatitis Victoria. Surely, with all the alcohol and smoking campaign ads, we would be more aware of an equally significant issue. But no, it is not as widely

Although, what’s really important is to look beyond the social stigma and see hepatitis, as a preventable and eradicable virus. Similar to how we currently view the yearly flu season. Not only is hepatitis C now curable, but there are many facilities out there, that can provide the support needed to overcome and prevent the virus. There is nothing but ourselves now to keep us from taking action and completely eliminating this virus from the face of the earth.

Gordon’s message to others: Prevention of the problem is always better than curing it. All it takes, is just your initiative. No more.

recognised as it probably should be.

Make sure you’re HEPReady Dealing with treatment adherence At the time of going to print Hepatitis Victoria was gearing up to officially launch the 2017 HEPReady training program for health and community workers.

EPReady’s suite of training courses have been developed specifically for community and health workers, including: practice and mental health nurses; social workers; AOD workers; aged care and youth workers; and Pharmacists. HEPReady courses are informed by lived experience, devised and facilitated by expert trainers; and, can be tailored for your organisation, delivered online via webinar as a tutorial style interactive discussion or to your organisation or group. Hepatitis Victoria is grateful for the significant financial support from the Helen Macpherson Smith Trust (HMS Trust) that has enabled the development of the HEPReady program. Speaking ahead of the launch, Lin Bender, Chief Executive of HMS Trust said: Building organisational capacity is one of HMS Trust’s core objectives, and the methodology undertaken by Hepatitis Victoria in developing the HEPReady program is a case-book study. Four Victorians die every week from viral hepatitis and we know that early diagnosis saves lives. Not only will HepReady’s far-reaching training program encourage systemic change in the diagnosis and treatment of viral hepatitis, the program is a fully scoped social enterprise model that supports the goal of eliminating viral hepatitis by 2030. Our grant in support of the HEPReady program highlights the Trust’s focus on longterm impact for the benefit of Victoria.

HEPReady Comprehensively Comprehensive Training HEPReady has just released its Comprehensive training package which has been developed to deepen the understanding and skills of our health and community workforce about caring for people with hepatitis.

Why “Comprehensive”?

and infection control; strategies to ensure adherence to treatment; strategies to help women who are pregnant and have just found out they have hepatitis – ‘what about the effects on the baby?’ And much more.

We figure that the health workforce wants training that is relevant to their actual work - in a community health centre, hospital or pharmacy. But they want training to extend beyond the work experiences they have already acquired. And not just knowledge, but skills and techniques that will be applicable across the range of client care relationships. Hepatitis is at the core of HEPReady training - clear, clinical information about its transmission and treatment, so that we can competently counter the myths that flourish in various communities - myths of contagion, ‘it’s easy to catch from an infected person, you can get it from sharing utensils, a spit in the eye, mosquitoes’, etc. But hepatitis, like mental illness, physical disability, obesity, etc. attracts a shocking stigma: ‘it’s brought on by bad behaviour, they deserve it because they used and shared dirty needles’, etc. We know this stigma is internalised by the person with hepatitis: it causes feelings of shame and often makes people afraid to come forward to be tested in case they need to reveal their hepatitis to their family and friends. HEPReady Comprehensive training is really focused on developing the workforce’s indepth level of understanding, assisting them in developing patient care skills that are applicable across the health spectrum: empathetic support; client counselling; helping people navigate the complex health treatment system of GPs, specialists, hospitals, health centres, pharmacies, etc. so they don’t get lost and confused; strategies to change behaviour; techniques for safe injecting practices

The packaging and delivery of HEPReady Comprehensive has been developed based on feedback from health and community workers views on what is needed with respect to hepatitis training. The modules kick off with a video presentation by a range of experts - nurses, GPs, nutritionists, gastroenterologists, researchers, epidemiologists. Extensive reading material is provided, all available online. Armed with this information, the course participants then participate in an hour long online Web Tutorial at a time that best suits them. The Tutorial is an interactive session where everyone has a microphone/ headset and can contribute equally, just as they would in a normal face-toface context. Most importantly, HEPReady Comprehensive is flexible. It allows a health worker, at a very reasonable fee, to select any one of the 17 unit offerings. They can package them as they want – focussing on specific areas of interest. Participants who select and complete four online units, and also attend a practical skills based class (3 hours) receive a Certificate of Completion (Comprehensive), which attracts CPD points. Ultimately,these courses are designed to accelerate the health and community workforce’s contribution to eliminating hepatitis.

Reece Lamshed HEPReady Business Development Manager

Comprehensive unit options Epidemiology B

Epidemiology C

Liver Conditions

Stigma and Empathy

The Chinese Testing B Testing C Chronic hepatitis Community

Treatment B Treatment C Infection Control

Health Treatment System Hepatitis Prevention

Alcoholic hepatitis Comprehensive and Fatty Liver (Practical) Disease

People who Inject Drugs Mothers and Babies Migrants and Refugees

Talking about HEPSpeakDealing with treatment adherence Name: Zoe Kelley Years active as a Hep speaker: 2â&#x20AC;&#x201C;3 years

medical professionals. My engagements have mainly focused on my journey living with hep C as well as the stigma of the illness, and the issues people face navigating the medical system and seeking support when needed. How do you think Hep speak helps to reduce stigma and discrimination?:

What does being a Hep speaker mean to you? For me, being a Hep speaker means I am able to share my story with others to help fight the stigma and stereotypes associated with the virus. I also want to help motivate others living with the virus to not be afraid to speak up or seek assistance with their illness, and help raise awareness within the community of the issues people living with Hep C face. What are the different types of speaking engagements you have undertaken?: I have spoken at the Parliamentary enquiry, I have spoken to groups of drug and alcohol counsellors and also spoken to groups of

People speaking out about hep C and sharing their stories helps to put a face to the illness. Often people will only focus on the stereotypes of people who suffer this illness. Putting a face and a story to the illness makes it a lot more personal for others. This helps others to understand the issues people face. Speaking out also raises awareness about discrimination people face not only from the community but also the medical profession.

I also speak publicly about hep C because I want to raise awareness of the new treatment options for people living with hep C who are afraid to seek help or treatment. I want to assist and educate others who live with this illness to hopefully free them from the struggles of living with hep C. Community education is also very important to me because education raises awareness and breaks down barriers. HEPSpeak bookings can be organised via our website (http://www.hepvic.org.au/ page/30/hepspeak) or by calling us on (03) 9380 4644.

What is some of the feedback you have been given from audience members of HEPSpeak?: I have been told many times from audience members how powerful my story has been for them and that it has helped to change their views on the stigma associated with the illness because my story is so unique. Often people comment on the lack of knowledge they had about the stigma and discrimination people living with hep C face.

In addition to HEPSpeak we have a number of Community Participation and Support programs including a FREE phone peersupport service called HEPConnect â&#x20AC;&#x201C; which is run by people living with hepatitis C and hepatitis B for people living with hepatitis C and hepatitis B. Phone our Infoline on 1800 703 003 to find out more.

Here’s to your good health! by Damian Salt, recipes by Harmandeep Kaur TOP 10 Fitness trends of 2017 #1 Wearable Technology – fitness tracker sales are expected to hit $4 Billion in 2017. #2 Bodyweight Training- no equipment necessary, perfect for quick office workouts or during travel. Some examples: push ups, chin ups, tricep push downs. #3 HIIT – short bursts of exercise at maximum or near maximum heart rate. Try running up a flight of stairs fast and repeat.

#4 Educated and experienced fitness professionals –engage in science backed workouts and reduce risk of injury.

#5 Strength Training – preserve muscle mass and boost your metabolism. Strength training for 10 weeks can boost your metabolic resting rate by 7%.

#6 Group Training- build accountability and have more fun. Also scientifically proven to help you work out longer #7 Exercise as medicine - exercise is proven to help your: Memory Sleep Energy levels Goal setting success Strength and flexibility Work performance Confidence Immune system Live longer – About 150 mins of moderate exercise or a 30 min session 5 times a week increases your life span by 3.4 years

• • • • • • • • •

#8 Yoga – yoga is an ancient exercise that never seems to go out of style. #9 Personal Training - looking for the oneon-one experience and targeted exercise, the personal trainer is for you. #10 Exercise and weight loss- nutrition is the key and so are your workouts. Make sure you find a workout you love so that you will stick to it.

My tips for the month I have found with most routines and diet, realistic goal setting is key to achieving what you set out to do. I completed the “Hep C Take Control” self-management course last year and goal setting was at the core of most of the exercises. It helped me address sleep issues and exercise routines by looking at the triggers that sometimes get in the way of not achieving goals and putting mechanisms in place that stopped me from throwing in the towel when a trigger raised its head. If you want to get involved in the next chronic disease self-management course ( Hep B, Hep C and other liver conditions such as fatty liver or cirosis) or find out about it, email; kate@hepvic.org.au or call Hepatitis Victoria 03 9380 4644 for dates and times.

My challenge of the month: The Water Challenge http://h30challenge.com.au/the-challenge switch from sugary drinks to water for 30 days and reap the rewards!

Breakfast of the month

Banana and cinnamon porridge INGREDIENTS

• • • • • • •

3 cups reduced-fat milk 1 1/2 cups traditional rolled oats Pinch of salt 1 1/2 tablespoons brown sugar 2 medium bananas, sliced diagonally 1 teaspoon ground cinnamon Select all ingredients

METHOD Step 1 Bring milk to a simmer in a large saucepan over medium-high heat. Stir in oats and salt. Bring to the boil. Reduce heat to medium. Cook, stirring with a wooden spoon, for 5 minutes or until porridge thickens (porridge will coat the spoon when ready). Step 2 Remove from heat. Cover and stand for 5 minutes (porridge will cool and thicken slightly on standing). Stir in sugar. Step 3 Spoon into bowls. Top with banana and cinnamon. Serve.

Reference: https://draxe.com/fitness-trends/ Take a closer look at the pros and cons of each.

Damian Salt

Interview with Peter Revill Pursuing a cure for hepatitis B liver damage and liver cancer, but they don’t completely rid the body of the infection. So, the two hepatitis viruses are very different the similarity is in the problems they cause in the liver but not in how they work or infect the body.

LT: Are there any promising drugs in development or being trialed? PR: Yes, there is a burgeoning interest,

With a lot of excitement around hepatitis C cures people living with hepatitis B (HBV) have been contacting the Hepatitis Victoria Infoline about a cure for hepatitis B. Lien Tran interviewed Associate Professor Peter Revill to get some answers about a cure.

eter is a senior hepatitis B researcher at Victorian Infectious Diseases Reference Laboratory (VIDRL) at the Peter Doherty Institute for Infection and Immunity, and President of the Australian Centre for Hepatitis Virology (ACHV). He is also Chair of a new international research initiative, the International Coalition to Eliminate HBV (ICEHBV) which is a group of leading researchers across the world who are combining their brain power to advance HBV cure.

LT: Thanks Peter, for talking to Good Liver. Can you tell us why scientists have found a cure for hepatitis C but not hepatitis B? PR: It’s because they are totally different viruses. Hepatitis C is easier to reach in the liver and when we target the virus with new drugs it eradicates the virus. In contrast, hepatitis B has a hidden reservoir in the liver cell that is not targeted by the current treatments meaning that if conditions are right, the virus can pop out and keep the infection going. This is why treatment for many patients is life-long. The treatments are good in that they reduce the amount of virus in the body and reduce the likelihood of

as hepatitis C can now be cured for many people, so pharmaceutical companies are turning their attention to hepatitis B. A cure is going to need a two-pronged approach, targeting the virus and at the same time helping the body fight the infection by enhancing the immune response. Another exciting approach is to use a drug to block viral entry, and there are a number of new drugs are in early stage clinical trial which is exciting.

LT: How far are we away from a cure? PR: A hepatitis B cure is still a number of years away and there is an urgent need for increased government funding of HBV cure research to facilitate this. With a coordinated global approach to developing a cure, we believe one could be available within the next ten years.

LT: Why will it take that long? PR: Well it’s a tricky virus as we have already discussed. One of the major reasons though is that hepatitis B research has been and still is poorly funded. We need more investment in research to progress new initiatives to help this happen. 240 million people worldwide and over 220,000 Australians live with chronic hepatitis B. Untreated, it causes liver disease and liver cancer, and treatment for most patients is life-long. It is important to also mention that 90,000 people in Australia do not know that they are infected, which means they are not receiving lifesaving treatment. We need improved access to testing and treatment, as well as a cure.

LT: How does your new coalition ICE-HBV help advance the possibility of hepatitis B cure? PR: By establishing ICE-HBV and bringing everyone together we are going to speed

up the process of finding answers. We have brought together the best minds in this field of research to collaborate. We will ensure people are working together on the right things and not duplicating efforts. Importantly, this is a global initiative, with representatives from all parts of the world where HBV is a major problem. There is real enthusiasm for this approach. Our ICE-HBV working groups are already getting together and coming up with new ideas, it’s fantastic. We believe this approach will lead to quicker advancement of HBV cure We also think it is really important for the HBV affected community to be involved and we will have community participation, as part of this initiative. This inspires our scientists and directs our research. It really helps researchers focus on why we are doing this work.

LT: Is there anything then affected community can do to help the research progress? \PR: I think getting involved with community organisations like Hepatitis Victoria that will partner with ICE-HBV and participate in events and strengthen the momentum. It is so important that governments worldwide recognize the public health burden of hepatitis B and fund research accordingly. \LT: How will people living with hepatitis B get updates on search for a cure is progressing? \PR: Through our website www.ice-hbv.org and through consumer organisations like Hepatitis Victoria and Hepatitis Australia, who will help us tell the community but also get feedback from the community about what you want us to work on.

LT: Thank you for your time Peter and could we ask you to update Good Liver if there is an advance in the quest for hepatitis B cure? PR: Thank you, my pleasure.

By Lien Tran and Nicole Allard, with questions also supplied by Nafisa Yusff.

Liver clinics and liver specialists Albury

Albury Community Health - Hepatitis Clinic 596 Smollett Street, Albury Contact: (02) 6058 1800 Fax: (02) 6058 1801

Bairnsdale

Bairnsdale, Regional Hospital, Specialist Consulting Rooms 122 Day Street, Bairnsdale Contact: (03) 5150 3478 Fax: (03) 5150 3404

Ballarat

Ballarat Health Services 577 Drummond Street North, Ballarat Contact: (03) 5320 4211 Fax: (03) 5320 4097 Ballarat Community Health 12 Liliburne Street, Lucas Contact: (03) 5338 4500

Bendigo

Bendigo Health Lucan Street, Bendigo Contact: (03) 5454 8422 Fax: (03) 5454 8419

Bentleigh East

Moorabin Specialist Centre (Private) 873 Centre Road, Bentleigh East Contact (03) 9579 0100 Fax: (03) 9563 7554

Berwick

76 Clyde Street, Berwick Contact: (03) 9796 1500 Fax: (03) 9796 1300

Box Hill

Box Hill Hospital 8 Arnold Street, Box Hill 3128 Contact: (03) 9895 3352 (OPD) 1300 342 255 (General)

Caulfield South

Caulfield Endoscopy (Private) 544 Hawthorn Road, Caulfield South Contact: (03) 9595 6666 Fax: (03) 9595 6611 Email: info@caulfieldendoscopy.com.au

Clayton

Southern Health Monash Medical Centre 246 Clayton Road, Clayton Contact: (03) 9594 6666 Fax: (03) 9594 6111 Email: outpatient.enquiries@monashhealth.org

Coburg

John Fawkner Private Hospital (Private) 275 Moreland Road, Coburg Contact: (03) 9385 2500 Fax: (03) 9385 2170

Cranbourne

Cranbourne Integrated Care Monash Health 140 -154 Sladen Street; Cranbourne Contact: (03) 5990 6789 Fax: (03) 5990 6350

East Ringwood

Maroondah Hospital – Eastern Health Davey Drive, Ground Floor Outpatients. East Ringwood Contact: (03) 9879 1570 Email: outpatients@easternhealth.org.au

Eltham

(Dr.Tony, Dr Michealson, and weakly visiting Hepatitis C nurse Rhonda O’Malley) 1170 Main Road, Eltham. Contact: (03) 9496 6846 Fax: 9496 2732 Email: Rhonda.o’malley@austin.org.au

Epping

Northern Hospital 185 Cooper Street, Epping Contact: (03) 8405 8000 Fax: (03) 8405 8761 Epping Medical Centre 230 Cooper Street Contact: (03) 8401 1777 Fax: (03) 8401 1788

Fitzroy

St. Vincent’s Hospital 35 Victoria Parade, Fitzroy Contact; (03) 9288 3771 Fax: (03) 9288 3489

Footscray

Western Hospital 148 Gordon Street, Footscray Contact: (03) 8345 6666 Fax: (03) 8345 6856

Frankston

Peninsula Liver Clinic (Private) 141 Cranbourne Road, Frankston Contact: (03) 9770 0139 Fax: 9781 2644

Geelong

University Hospital Geelong 292-322 Ryrie Street, Geelong Contact: (03) 4215 1396 Fax: (03) 4215 1385 155 Guthridge Parade, Sale.

Gippsland

Central Gippsland Health Services 155 Guthridge Parade, Sale Contact: (03) 5143 8600

Heidelberg

Austin Liver Clinic 145 Studley Road, Heidelberg Contact: (03) 9496 2787 Fax: (03) 9496 7232

Malvern

Victorian HepatoPancreato Biliary Surgery Group. (Private) 29/183 Wattletree Road, Malvern Contact: (03) 9508 1222 Fax: (03) 9509 1522 Cabrini Hospital (Private) 183 Wattletree Road, Malvern Contact: (03) 9508 1222 Fax: (03) 9508 1098

Maroondah

Maroondah Hospital – Eastern Health (Outpatients) Ground Floor, Davey Drive, Ringwood East Contact: (03) 9895 3333 Fax: (03) 9895 4852

Melbourne

Alfred Centre, Gastroenterology Department Ground Floor, 99 commercial Road, Melbourne Contact: (03) 9076 2223 Fax: (03) 9076 2194 Melbourne City Gastroenterology (Private) Mailing address: Melbourne City Gastroenterology PO Box 2159 Royal Melbourne Hospital Contact: 1300 700 789

Melbourne East

Melbourne GI & Endoscopy (Private) 130-132 Grey Street, East Melbourne Contact: (03) 9417 5306

Mildura

Mildura Base Hospital 231-237 Thirteenth Street, Mildura Contact: (03) 5022 3333 Fax: (03) 5033 3228

Mitcham

Mitcham Private Hospital – consulting rooms (Private) 23 Doncaster East Road, Mitcham Contact: (03) 9210 3146 Fax: (03) 9210 3139

Moonee ponds

Moonee ponds Gastrolab (Private) Suite 1, Level 1, 28 Young Street, Moonee Ponds Contact: (03) 9331 3122 Fax: (03) 9331 3133 Moonee Valley Specialist Centre (Private) Private Facility, including Fibroscan. Ground Leve| 767 Mt Alexander Road Moonee Ponds Contact: (03) 9372 0372

Parkville

Royal Melbourne Hospital, Infection Diseases Department, OPD Ninth floor, 300 Grattan Street (Corner of Royal Parade), Parkville Contact: (03) 9342 7212 Fax: (03) 9342 7277

Contacts

Community-based Hepatitis C Treatment Services Prahran

Alfred Hospital, Infectious Diseases Department 55 Commercial Road, Prahran Contact: (03) 9076 6081 Fax: (03) 9076 6528

Preston

Victorian Aboriginal Health Services Wednesdays 9.00-4.00pm 238-250 Plenty Road Preston Phone: 9403 3300 for an appointment or drop in.

Richmond

The Epworth Centre (needs referrals) Suite 7.6 Erin Street, Richmond Contact: (03) 9428 9908 Fax: (03) 9421 3432

Shepparton

Community based treatment clinics have been developed to enable more people to access treatment in their local communities.

Ballarat

Ballarat Community Health 12 Lilburne Street, Lucas Contact: (03) 5338 4500 Fax: (03) 5338 0520

Braybrook

Braybrook Community Health Service Cohealth Churchill Avenue, Braybrook

Coburg

St. Kyrollos Family Clinic 2A Moore Street, Coburg Contact: (03) 9386 0900 Fax: (03) 9386 5388

Kensington

cohealth – Kensington Medical Clinic, 12 Gower Street, Kensington VIC 3031 Contact: (03) 8378 1600

Melbourne

Living Room, Youth Projects (Hepatitis programs – Thursdays every fortnight) 7 – 9 Hosier Lane, Melbourne Contact: (03) 9662 4488 Fax: (03) 9662 4400 Email: living@youthprojects.org.au

North Melbourne

Harm Reduction Victoria (HRV) 128 Peel Street, North Melbourne Contact: (03) 9329 1500 Email: admin@hrvic.org.au

Nunawading

Goulburn Valley Health Outpatients Graham Street, Shepparton Telephone: (03) 5832 3600 Fax: (03) 5831 6032

Coburg

Uniting Care Re Gen 26 Jessie Street, Coburg Contact: (03) 9386 2876

Nunawading Clinic 176 Springvale Road, Nunawading Contact: (03) 9878 9191 Fax: (03) 9877 2089

Springvale

Collingwood

Richmond

Springvale Community Health – Monash Medical Centre 55 Buckingham Avenue, Springvale Contact: (03) 9594 3088

Traralgon Latrobe Regional Hospital Private Consulting Suites 3 and 4 Princes Highway, Traralgon West. Contact: (03) 5173 8111 Fax: (03) 5173 8097 Wantirna

Knox Private Hospital – consulting rooms (Private) 262 Mountain Highway, Wantirna Contact: (03) 9210 7300 Fax: (03) 9210 7301

Warrnambool

Western Region Alcohol and Drug Centre (limited hepatitis treatment services) 172 Merri Street, Warrnambool Contact: 1300 009 723 Fax: (03) 5564 5700

West Heidelberg Banyule Community Health Centre 21 Alamein Road, West Heidelberg. Contact: (03) 9496 6846 Wodonga

Murray Valley (Private) Hospital Nordsvan Drive, Wodonga. Contact: (02) 6056 3366 Fax: (02) 6056 3466 Gateway Health 155 High Street, Wodonga Contact: (02) 6022 8888 Fax: (02) 6024 5792

coHealth (formerly North Yarra Community Health) 365 Hoddle Street, Collingwood Contact: (03) 9411 3555 Fax: (03) 9411 4300 Email: info@cohealth.org.au Cohealth INNERSPACE 4 Johnston Street, Collingwood

Cranbourne

Cranbourne Intergrated Care Centre – Monash Health (Hepatitis C outreach treatment clinic as part of Southern Health Services) 140 -154 Sladen Street, Cranbourne Contact: (03) 5990 6789

Fitzroy

cohealth 75 Brunswick Street Fitzroy Contact: (03) 9411 3555 Fax: (03) 9411 3500

Footscray

Health Works 4 –12 Buckley Street, Footscray Contact: (03) 9362 8100 Fax: (03) 9362 8180

Footscray

cohealth Joslin clinic 575 Barkly Street, West Footscray Contact: (03) 9912 2000

Frankston

SHARPS, NSP + community health 20 Young Street, Frankston Contact: 1800 642 287

North Richmond Community Health (Hepatitis C nurse visits every Wednesday) 23 Lennox Street, Richmond Contact: (03) 9418 9800 Fax: (03) 9428 2269 Email: nrch@nrch.com.au

St. Kilda

Barkley Street Medical Centre 60 Barkley Street, St. Kilda Contact: (03) 9534 0531 Fax: (03) 9534 6159 FIRST STEP 42 Carlisle Street, St Kilda Contact: (03) 9537 3177 Fax: (03) 9537 0133 Access Health 31 Grey Street, St Kilda Contact: (03) 9076 6081 St Vincent’s Integrated Hepatitis C Service 60 Barkly Street. St Kilda Contact: (03) 9534 0531

Warragul, Morwell, Sale

La Trobe Community Health Service, Hepatitis C Nurse 1800 242 696

Werribee

Werribee Mercy Hospital consulting suites 300 Princess Highway, Werribee Contact: (03) 9386 2259 Fax: 8754 3110

Wodonga

Gateway Health Service 155 High Street Wodonga VIC 3690 (03) 5723 2000

Contacts

Needle and Syringe Programs Alexandra

Bendigo

Altona Meadows

After hours: Bendigo Community Health Service Mobile Outreach NSP Tuesday-Saturday 7.30-10.45pm Contact: 1800 636 514

Apollo Bay

Bendigo Community Health Service Mobile Drug Safety Worker 13 Helm Street, Kangaroo Flat Contact: 0409 326 460

Alexandra Community Health Services – Needle Exchange Program 12 Cooper Street, Alexandra Contact: (03) 5772 0900 Fax: (03) 5772 0919 Email: alexandrachs@humehealth.org.au Isis Primary Care 330 Queens Street, Altona Meadows Contact: (03) 8368 3000 Fax: (03) 9360 7534 Otway Health & Community Services 75 McLachlan Street, Apollo Bay Contact: (03) 5237 8500 Fax: (03) 5237 6172 Email: otwayhealth@swarh.vic.gov.au

Ararat

Priceline Pharmacy 119 Barkly Street, Ararat Contact: (03)5352 1007 Fax: (03) 5352 2115

Bairnsdale

Bairnsdale Community Health Centre – Needle and Syringe Program 48 Ross Street, Bairnsdale Contact: (03) 5152 0222 Fax: (03) 5152 1500 Email: email@brhs.com.au Bairnsdale Community Health Centre – Emergency Department offer needles 24/7 122 Day Street, Bairnsdale Contact: (03) 5150 3333 Fax: (03) 5152 6784 Email: email@brhs.com.au

Belgrave

Inspiro Community Health Service 1624 Burwood Highway, Belgrave Contact: (03) 9738 8801 Fax: (03) 9739 4689 Email: hello@inspiro.org.au

Belmont

Barwon Health – Needle and Syringe Program 1-17 Reynolds Road, Belmont Contact: (03) 4215 6800 Fax: (03) 4215 6839 Email: receptionbelmont@barwonhealth.org.au

Benalla

Benalla Community Health 45 Coster Street, Benalla Contact: (03) 5761 4222 Fax: (03) 5761 4502 Email: communityhealth@benallahealth.org.au

Bendigo Central Secondary NSP Bendigo Community Health Service 171 Hargreaves Street, Bendigo Contact: (03) 5448 1600

Bentleigh East

Bentleigh Bayside Community Health, Glen Eira Site 2A Gardeners Road, Bentleigh East Contact: (03) 9575 5333 Fax: (03) 9579 3623 Email: info@bbch.org.au

Carlton North

cohealth, Carlton North Centre 622 Lygon Street, Carlton North Contact: (03) 9349 7333 Fax: (03) 9349 7300 Email: info@cohealth.org.au

Castlemaine

Castlemaine District Community Health Centre 13 Mostyn Street, Castlemaine Contact: (03) 5479 1000 Fax: (03) 5472 3221 Email: email@cdch.com.au

Caulfield

Caulfield Community Health Service – Alfred Health 260 Kooyong Road, Caulfield Contact (03) 9076 6666 Fax: (03) 9046 4060 Email: access@cgmc.org.au

Chelsea

Priceline Pharmacy Blackburn 109 Canterbury Road, Blackburn South Contact: (03) 9877 2525 Fax: (03) 9877 2522

Central Bayside Community Health Service 3/1 The Strand, Chelsea Contact: (03) 9782 7633 Fax: (03) 9782 7600 Email: info@cbchs.org.au

Braybrook

Churchill

Blackburn South

cohealth, Braybrook Community Centre 107-139 Churchill Avenue, Braybrook Contact: (03) 9334 6699 Fax: (03) 9312 3507

Broadmeadows

Dianella Community Health 42-48 Coleraine Street, Broadmeadows Contact: (03) 8301 8888 Fax: (03) 8301 8889

Brunswick

Merri Community Health Services 11 Glenlyon Road, Brunswick Contact: (03) 9367 6711 Fax: (03) 9387 5417 Email: mchs@mchs.org.au

Camperdown

Manifold Place Community Health Centre 140 Manifold Street, Camperdown Contact: (03) 5593 1892 Fax: (03) 5593 2010 Email: MPlace2@swh.net.au

Cann River

Cann Valley Bush Nursing Centre 27 Monaro Highway, Cann River Contact: (03) 5152 6210 Fax: (03) 5158 6409

Carlton

Melbourne Sexual Health Centre 580 Swanston Street, Carlton Contact: (03) 9341 6200 Fax: (03) 9341 6279 Email: enquiries@mshc.org.au

Latrobe Community Health Service 20 - 24 Philip Parade, Churchill Contact: 1800 242 696 Fax: (03) 8746 1100 Email: info@lchs.com.au

Cobram

Cobram District Health 24 - 32 Broadway Street, Cobram Contact: (03) 5871 0777 Fax: (03) 5872 2406

Coburg

Merri Community Health Services 93 Bell Street, Coburg Contact: (03) 9350 4000 Fax: (03) 9350 1518 Email: mch@mchs.org.au

Cockatoo

Monash Health Community Services 7 - 17 McBride Street, Cockatoo Contact: (03) 5968 7000 Fax: (03) 5968 7030 Email: MHCAccess@monashhealth.org

Colac Colac Area Health 2-28 Connor Street, Colac Contact: (03) 5232 5100 Email: dmelville@cah.vic.gov.au

Collingwood

cohealth 4 Johnston Street, Collingwood Contact: (03) 9468 2800 Fax: (03) 9417 1499 Email: info@innerspace.org.au 365 Hoddle Street, Collingwood Contact: (03) 9411 4333 Fax: (03) 9411 4300 Email: info@cohealth.org.au

Corio

Barwon Health - Needle Syringe Program 2 Gellibrand Street, Corio Contact: (03) 4215 7100 Fax: (03) 4215 7193

Corryong

Upper Murray Health and Community Services 20 Kiell Street, Corryong Contact: (03) 6076 3200 Fax: (03) 6076 1739 Email: Enquiries@umhcs.vic.gov.au

Eltham

Nillumbik Health 917 Main Road, Eltham Contact: (03) 9430 9100 Fax: (03) 9431 0339 Email: nchs@nillumbikhealth.org.au

Epping

Plenty Valley Community Health 187 Cooper Street, Epping Contact: (03) 9409 8787 Fax: (03) 9408 9508

Euroa

Euroa Health 36 Kennedy Street, Euroa Contact: (03) 5795 0200 Fax: (03) 5795 0240 Email: eh@euroahealth.com.au

Fitzroy

Cranbourne

Turning Point Alcohol & Drug Centre 54-62 Gertrude Street, Fitzroy Contact: (03) 8413 8413 Fax: (03) 9416 3420 Email: info_group@turningpoint.org.au

Dandenong

cohealth 75 Brunswick Street, Fitzroy Contact: (03) 9411 3555 Fax: (03) 9411 3500 Email: info@cohealth.org.au

Monash Health Community 140 - 154 Sladen Street, Cranbourne Contact: (03) 5990 6789 Fax: (03) 5990 6328

Community Access Partnership (CAP) 84 Foster Street, Dandenong Contact: (03) 9792 7630 Fax: (03) 9794 0979 Email: SEADS@monashhealth.org.au

Fitzroy North

Deer Park

Footscray

Graeme Wurm Pharmacy 104 Station Road, Deer Park Contact: (03)9363 4204 Fax (03) 9363 3342

Drysdale

Silverii’s Pharmacy 333 St Georges Road, Fitzroy North Contact: (03) 9481 0671 Fax: (03) 9482 6855 Health Works, cohealth 4 -12 Buckley Street, Footscray Contact: (03) 9362 8100 Fax: (03) 8362 8180

Frankston

Bellarine Community Health 21 Palmerstone Street, Drysdale Contact: (03) 5251 2291 Fax: (03) 5258 0864

Frankston City Council 30 Davey Street, Frankston Contact: (03) 9784 1888 Fax: (03) 9784 1094

Eaglehawk

Frankston Integrated Health Centre 12-32 Hastings Road, Frankston Contact: (03) 9784 8100 Fax: (03) 9784 8149

Bendigo Community Health Services, Eaglehawk 3 Seymoure Street Eaglehawk Contact: (03) 5434 4300 Fax: (03) 5434 4355 Email: bchs@bchs.com.au

Echuca

Echuca Regional Health 226 Service Street, Echuca Contact: (03) 5485 5000 Fax: (03) 5482 5478 Email: erhexec@erh.org.au

Southern Hepatitis/HIV/AIDS Resources & Prevention Services (SHARPS) 20 Young Street, Frankston Contact: (03) 9781 1622 Fax: (03) 9781 3669 Email: customer.relation@phcn.vic.gov.au

Geelong

Wathaurong Aboriginal Cooperative 62 Morgan Street, Geelong North Contact: (03) 5277 2038 Fax: (03) 5277 3537 Email: healthservice@wathaurong.org.au

Glenroy

Youth Projects – Foot Patrol Needle and Syringe Program 6 Hartington Street, Glenroy Contact: (03) 9304 9100 Fax: (03) 9304 9111 admin@youthprojects.org.au

Gisborne

Macedon Ranges Health 5 Neal Street, Gisborne Contact: (03) 5428 0300 Fax: (03) 5428 0399 Email: healthcare@mrh.org.au

Greensborough

Banyule Community Health Service, Greensborough Centre – Needle Syringe Program Unit 3, 25-33 Grimshaw Street, Greensborough Contact: (03) 9433 5111 Fax: (03) 9435 8922 Email: banyule@bchc.org.au

Hastings

Hastings Community Health Service 185 High Street, Hastings Contact: (03) 5971 9100 Fax: (03) 5971 9106

Hawthorn

Swinburne University Health Services Level 4, George Swinburne Building, 34 Wakefield Street, Hawthorn Contact: (03) 9214 8483 Fax: (03) 9818 7548 Email: healthservice@swin.edu.au

Healesville

Healesville & District Hospital – Needle Exchange Program 377 Maroondah Highway, Healesville Contact: (03) 5962 4300 Fax: (03) 5962 3429

Heidelberg West

Banyule Community Health Service – Needle Syringe Program 21 Alamein Road, Heidelberg West Contact: (03) 9450 2000 Fax: (03) 9459 5808 Email: banyule@bchs.org.au

Horsham

Wimmera Health Care Group 83 Baillie Street, Horsham Contact: (03) 5381 9111 Fax: (03) 5381 9196 Email info@whcg.org.au

Kangaroo Flat

Bendigo Community Health Services, Kangaroo Flat Site 13 Helm Street, Kangaroo Flat Contact: (03) 5430 0500 Fax: (03) 5430 0544 Email: bchs@bchs.com.au

Contacts Kyneton

Cobaw Community Health Service 47 High Street, Kyneton Contact: (03) 5421 1666 Fax: (03) 5422 2161 Email: admin@cobaw.org.au

Lakes Entrance

Mildura

Pakenham

Moe

Portarlington

Mornington

Portland

Sunraysia Community Health Service 137 Thirteenth Street, Mildura Contact: (03) 5022 5444 Fax: (03) 5022 5445 Email: schs@schs.com.au

Gippsland Lakes Community Health Centre 18-26 Jemmeson Street, Lakes Entrance Contact: (03) 5155 8300 Fax: (03) 5155 4057 Email: contact@glch.org.au

Latrobe Community Health Services 42-44 Fowler Street, Moe Contact: 1800 242 696 Fax: (03) 5127 7002 Email: info@lchs.com.au

Leongatha

Gippsland Southern Health Services Koonwarra Road, Leongatha Contact: (03) 5667 5555 Fax: (03) 5667 5516 Email: info@gshs.com.au

Mornington Community Information and Support Centre 320 Main Street, Mornington Contact: (03) 5975 1644 Fax: (03) 5975 5423 Email: manager@mcisc.org.au

Lilydale

Morwell

Lochsport

Myrtleford

Inspiro Community Health Service 17 Clarke Street, Lilydale Contact: (03) 9738 8801 Fax: (03) 9739 4689 Email: hello@inspiro.org.au

Loch Sport Community Health Centre 1 National Park Road, Loch Sport Contact: (03) 5146 0349 Fax: (03) 5146 0780 Email: lochsport@cghs.com.au

Lucas

Ballarat Community Health Centre – Needle Syringe Program 12 Lilburne Street, Lucas Contact: (03) 5338 4500 Fax: (03) 5332 6617 Email: info@bchc.org.au

Mansfield

Mansfield District Hospital 53 Highett Street, Mansfield Contact: (03) 5775 8800 Fax: (03) 5775 1352 Email: reception.main@mdh.org.au

Maryborough

Community Services Maryborough 75-87 Clarendon Street, Maryborough Contact: (03) 5461 0400 Fax: (03) 5461 4489

Melbourne

Melbourne City Council 200 Little Collins Street, Melbourne Contact: (03) 9658 9658 Fax: (03) 9658 9685

Melton

Djerriwarrh Health Service Yuille Street, Melton Contact: (03) 8746 1100 Fax: (03) 9743 8640

Latrobe Community Health Service 81-87 Buckley Street, Morwell Contact: 1800 242 696 Fax: (03) 5136 5450 Email: info@lchs.com.au

Gateway Health 32 Smith Street, Myrtleford Contact: (03) 5731 3500 Fax: (03) 5751 1822 Email: info@gatewayhealth.org.au

Newcomb

Newcomb Community Health Centre – Needle Syringe Program 104-108 Bellarine Highway, Newcomb Contact: (03) 4215 7520 Fax: (03) 4215 7795 Email: receptionnewcomb@barwonhealth.org.au

Northcote

Darebin Distric Health Service 42 Separation Street, Northcote Contact: (03) 9403 1200 Fax: (03) 9482 3690 Email: info@dch.org.au

Nowa Nowa

Nowa Nowa Community Health 6 Bridge Street, Nowa Nowa Contact: (03) 5155 7294 Fax: (03) 5155 7296 Email: email@nnch.org.au

Orbost

Orbost Regional Health 104-107 Boundary Road, Orbost Contact: (03) 5154 6666 Fax: (03) 5154 2366 Email: orh@orh.com.au

Monash Health Community 66-70 Princess Highway, Pakenham Contact: (03) 5941 0500 Fax: (03) 5941 0542 Email: mhcaccess@monashhealth.org Bellarine Community Health 39 Fenwick Street, Portarlington Contact: (03) 5258 6140 Fax: (03) 5258 0864 Email: intake@bch.org.au Portland District Health 141-151 Bentinck Street, Portland Contact: (03) 5521 0333 Fax: (03) 5521 8162 Email: pdh@swarh.vic.gov.au

Prahran

Inner South Community health Needle Exchange Program 240 Malvern Road, Prahran Contact: (03) 9525 1300 Fax: (03) 9521 2474 Email: adminenquiries@ischs.org.au

Reservoir East

Darebin Community Health 125 Blake Street, Reservoir East Contact: (03) 8470 1111 Fax: (03) 8470 1107 Email: info@dch.org.au

Richmond

North Richmond Community Health Needle and Syringe Program (NSP) 23 Lennox Street, Richmond Contact: (03) 9418 9800 Fax: (03) 9428 2269

Ringwood

EACH Ltd 46 Warrandyte Road, Ringwood Contact: 1300 003 224 Fax: (03) 9870 4688 Email: info@each.com.au

Ringwood East

EACH Ltd 75 Patterson Street, Ringwood East Contact: (03) 9837 3999 Fax: (03) 9879 6356 Email: info@each.com.au

Rosebud

Southern Peninsula Community Support and Information Centre 878 Point Nepean Road, Rosebud Contact: (03) 5986 1285 Fax: (03) 5982 2601 Email: admin@spcsic.org

Rosedale

Roosedale Community Health Service 2- 8 Cansick Street, Rosedale Contact: (03) 5199 2333 Fax: (03) 5199 2980 Email: rosedale@cghs.com.au

Sale

Central Gippsland Health Service, Divison of Community Care Palmerston Street, Sale Contact: (03) 5143 8800 Fax: (30) 5143 8890 Emaol: cs.reception@cghs.com.au

San Remo

San Remo Community Services 1 Back Beach Road, San Remo Contact: (03) 5671 9200 Fax: (03) 5678 5595

Sebastopol

Ballarat Community Health Centre Doctors Clinic – Needle and Syringe Program 260 Vickers Street, Sebastopol Contact: (03) 5338 4585

Shepparton

Primary Care Connect 399 Wyndham Street, Shepparton Contact: (03) 5823 3200 Fax: (03) 5823 3299 Email: support@primarycareconnect.com.au

South Melbourne

Inner South Community Health Services 341 Coventry Street, South Melbourne Contact: (03) 9690 9144 Fax: (03) 9696 7228 Email: adminenquiries@ischs.org.au

South Yarra

Victorian AIDS Council/ Gay Men’s Health Centre 6 Claremont Street, South Yarra Contact: (03) 9865 6700 Fax: (03) 9826 2700 Email: enquiries@vac.org.au

Springvale

Monash Health Community 55 Buckingham Avenue, Springvale Contact: (03) 8558 9080 OR (03) 8558 9000 Fax: (03) 8558 9011 Email: intakeGDCHS@southernhealth.org.au

St. Albans

Isis Primary Care 1 Andrea Street, St. Albans Contact: (03) 9296 1200 Fax: (03) 9366 2086

Stawell

Stawell Health & Community Centre 8-22 Patrick Street, Stawell Contact: (03) 5358 7400 Fax: (03) 5358 4113 Email: gch@grampianscommunityhealth.org.au

St. Kilda

Inner South Community Health Services 18 Mitford Street, St. Kilda Contact: (03) 9534 0981 Fax: (03) 9525 3730 Resourcing Health and Education in the Sex industry (RhED) 10 Inkerman Street, St. Kilda Contact: 1800 458 752 Fax: (03) 9525 4492 Email: sexworker@sexworker.org.au Salvation Army Health Information Exchange 29 Grey Street, St. Kilda Contact: (03) 9536 7703 Fax: (03) 9536 7778

Sunbury

Sunbury Community Health Centre 12-28 Macedon Street, Sunbury Contact: (03) 9744 4455 Fax: (03) 9744 6777 Email: admin@sunburychc.org.au

Warrnambool

Brophy Family & Youth Services 210 Timor Street, Warrnambool Contact: (03) 5561 8888 Fax: (03) 5561 8816 Email: admin@brophy.org.au Warrnambool Community Health Koroit Street, Warrnambool Contact: (03) 5563 4000 Fax: (03) 5563 1669

Wendouree

Ballarat Community Health Centre – Needle and Syringe Program 10 Learmonth Road, Wendouree Contact: (03) 5338 4500 Fax: (03) 5339 3044 Email: info@bchc.org.au

Wodonga

Timboon

Gateway Community Health, Wodonga 155 High Street, Wodonga Contact: (02) 6022 8888 Fax: (02) 6024 5792

Torquay

Bass Coast Health – Needle Syringe Program 237 Graham Street, Wonthaggi Contact: (03) 5671 3333 Fax: (03) 5671 3300

Timboon & District Healthcare Services 21 Hospital Road, Timboon Contact: (03) 5558 6000 Fax: (03) 5598 3565 Email: timboon@swarh.voc.gov.au Torquay Community Health Centre – Needle and Syringe Program 100 Surf Coast Highway, Torquay Contact: (03) 4215 7800 Fax: (03) 4215 7843 Email: chrisinfoaccess@barwonhealth.or.au

Traralgon

Latrobe Community Health Services Seymour Street, Traralgon Contact: 1800 242 696 Fax: (03) 5171 1470 Email: info@lchs.com.au

Wangaratta

Gateway Health 45-47 Mackay Street, Wangaratta Contact: (03) 5723 2000 Fax: (03) 5722 2313 Email: info@gatewayhealth.org.au Northeast Health 35-47 Green Street, Wangaratta Contact: (03) 5722 5239 Fax: (03) 5722 4382 Email: enquiries@nhw.hume.org.au

Warragul

Wonthaggi

Yarra Junction

Yarra Valley Community Health – Needle Exchange Program 2475 Warburton Highway, Yarra Junction Contact: 1300 342 255 Fax: (03) 5962 3429

Yarram

Yarram and District Health Centre Bakers Community Services Centre 121 Commercial Road, Yarram Contact: (03) 5182 0270 Fax: (03) 5182 0295 Email: youth+familyservices@ydhs.com.au

Yarrawonga

Yarrawonga Health 33 Piper Street, Yarrawonga Contact: (03) 5743 8111 Fax: (03) 5743 8118

Yea

Yea & District Memorial Hospital 45 Station Street, Yea Contact: (03) 5736 0400 Fax: (03) 5797 2391

West Gippsland Healthcare Group Community Services Division 31-35 Gladstone Street, Warragul Contact: (03) 5624 3500 Fax: (03) 5624 3555 Email: info@wghg.conm.au

Contacts

Alcohol and Drug Programs, Primary Health Care Centres (for PWID), Regional Services Bayswater

Anglicare Victoria 666 Mountain Highway, Bayswater Contact: (03) 9721 3688

Cobaw

Cobaw Community Health Service 47 High Street, Kyneton Contact: (03) 5421 1666 Fax: (03) 5422 2161 Email: admin@cobaw.org.au

Craigieburn

Anglicare Victoria 59 Craigieburn Road, Craigieburn Contact: (03) 9483 2401

Fitzroy

Youth Support + Advocacy Service (YSAS) Level 1, 131 Johnston Street, Fitzroy Contact: (03) 9415 8881 Fax: (03) 9415 8882 Email: reception@ysas.org.au Turning Point Alcohol & Drug Centre 54-62 Gertrude Street, Fitzroy Contact: (03) 8413 8413 Fax: (03) 9416 3420 Email: info_group@turningpoint.org.au

Frankston

Anglicare Victoria Level 2 / 60-64 Wells Street, Frankston Contact: (03) 9781 6700 Frankston Integrated Health Centre 12-32 Hastings Road, Frankston Contact: (03) 9784 8100 Fax: (03) 9784 8149

Geelong

Barwon Health – Alcohol and Drug Services 40 Little Malop Street, Geelong Contact: (03) 5273 4000 Fax: (03) 5273 4044

Lucas

Ballarat Community Health Centre – Mobile Drug Support Worker 12 Lilburne Street, Lucas Contact: (03) 5338 4500 Fax: (03) 5332 6617 Email: info@bchc.org.au

Melbourne

Druginfo Level 12, 607 Bourke Street, Melbourne Contact: 1300 85 85 84 Fax: (03) 8672 5983

Mildura

Drug Treatment Services 137 Thirteenth Street, Mildura Contact: (03) 5021 7694 Fax: (03) 5021 7695 Email: schs@schs.com.au

Portland

Portland District Health 141-151 Bentinck Street, Portland Contact: (03) 5521 0333 Fax: (03) 5521 8162 Email: pdh@swarh.vic.gov.au

Preston

Anglicare Victoria 42 Mary Street, Preston Contact: (03) 8470 9999

Richmond

Drug Safety Program 23 Lennox Street, Richmond Contact: (03) 9418 9800 Fax: (03) 9428 2269

Werribee

Anglicare Victoria 2 Market Road, Werribee Contact: (03) 9731 2500

Healesville

Yarra Valley Community Health Service (Once per month clinic- hepatis clinic Contact: 1300 130 381 Fax: (03) 5962 3429

Lucas

Ballarat Community Health 12 Lilburn Street, lucas Telephone: (03) 5338 4500 Fax: (03) 5338 0520 Email: info@bchc.org.au

Mildura

Sunraysia Community Health Centre 137 Thirteenth Street, Mildura Contact: (03) 5022 5444 Fax: (03) 5022 5445 Email: schs@schs.com.au

Morwell

Primary Health Care Centres (for PWID)

Moe Community Health Centre 81-87 Buckley Street, Morwell Contact: 1800 242 696 Fax: (03) 5136 5450 Email: info@lchs.com.au

Melbourne

Portland

Living Room, Youth Projects (Hepatitis programs – Thursdays every fortnight) 7 – 9 Hosier Lane, Melbourne Contact: (03) 9662 4488 Fax: (03) 9662 4400 Email: living@youthprojects.org.au

Mornington

The Bays Hospital Vale Street, Mornington Contact: (03) 5975 2009 Fax: (03) 5975 2373

Regional Services

These contacts are able to provide information about local viral hepatitis related services as well as active support groups.

Glenelg Southern Grampians (Drug Treatment Service) Bentinck Street, Portland Contact: (03) 5521 0350 Fax: (03) 5521 0625 Email: pdhspecialistcentre@swarh.vic.gov.au Dhauwurd-Wurrung Elderly and Community Health Service (Community Health Centre) 18 Wellington Rd, Portland VIC 3305 Contact: (03) 5521 7535 Fax: (03) 55211299

Shepparton

Primary Care Connect 399 Wyndham Street, Shepparton Telephone: (03) 5823 3200 Fax: (03) 5823 3299

Bendigo

Tatura

Eaglehawk

Torquay

Bendigo Health Lucan Street, Bendigo Contact: (03) 5454 6000 Fax: (03) 5454 8419 Eaglehawk Community House 19 Bright Street, Eaglehawk

Geelong

Barwon Mental Health, Drug and Alcohol Services 40 Little Malop Street, Geelong Contact: (03) 4215 8792 Fax: (03) 4215 8793 Jigsaw Youth Health Service Yarra Street, Geelong Contact: 1300 094 187 Fax: (03) 4215 8298

Tatura Medical Centre 4 Thomson Street, Tatura Telephone: (03) 5824 1244 Fax: (03) 5824 2551 Surf Coast Health Service - Barwon Health 100 Surfcoast Hwy, Torquay Telephone: (03) 4215 7850 Fax: (03) 4215 7889

Traralgon

Latrobe Regional Hospital Princess Highway, Traralgon Contact: (03) 5173 8000 Fax: (03) 5173 8444

Contacts

Related Health Services, Sexual Health, and Rural Services Wangaratta

Gateway Health 45-47 Mackay Street, Wangaratta Telephone: (03) 5723 2000 Fax: (03) 57222313 Email: infowang@gatewayhealth.org.au

Warragul

West Gippsland Hospital Landsborough Street, Warragul Contact: (03) 5623 0611 Fax: (03) 5622 6403 Email: info@wghg.com.au

Warrnambool

Western Region Alcohol and Drug Centre (WRAD) 172 Merri Street Warnambool 1300 009 723 Fax: (03) 5564 5700 Email: wrad@wrad.org.au

Wendouree

Ballarat Oncology and Haematology Services 1117 Howitt Street, Wendouree Contact: (03) 5339 8000 Fax: (03) 5339 8111

Wodonga

Gateway Health 155 High Street, Wodonga Contact: (02) 6022 8888 Fax: (02) 6024 5792 Email: info@gateqayhealth.org.au

Carlton Victorian Equal Opportunity and Human Rights Commission (Information on state and federal equal opportunity laws and programs) Level 3, 204 Lygon Street, Calrton Telephone 1300 891 848 Fax: 1300 891 858 Email: information@veohrc.vic.gov.au Web: www.humanrightscommission.vic.gov.au Hampton East

Haemophilia Foundation Victoria 13 Keith St, Hampton East, VIC 3188 Contact: (03) 9555 7595 Fax: (03) 95557375 Email: info@hfv.org.au

Prahran

Alfred– HIV:Hepatitis:STI Education and Resource Centre (Statewide resource centre on HIV/AIDS, Hepatitis and Sexually Transmissible Infections) 8 Moubray Street, Prahran Telephone: (03) 9076 6993 Fax: (03) 9076 5294 Email: erc@alfred.org.au Web: www.alfredhealth.org.au

Melbourne

Health Services Commissioner 26th Floor, 570 Bourke Street, Melbourne Free call: 1300 582 113 Fax: (03) 9032 3111 Email: hsc@dhhs.vic.gov.au Cancer Council Victoria – Living with Cancer Education Program 615 St. Kilda Road, Melbourne Contact: 13 11 20 Fax: (03) 9514 6800 Email: enquiries@cancervic.org.au

North Melbourne

Harm Reduction Victoria (HRV) 128 Peel Street, North Melbourne Contact: (03) 9329 1500 Fax: (03) 9329 1501

Southbank

Living Positive Victoria Suite 1 / 111 Coventry Street, Southbank Contact: (03) 9863 8733 Email: info@livingpositivevictoria@org.au

Sexual Health Box Hill

Family Planning Victoria 901 Whitehorse Road, Box Hill Contact: (03) 9257 0100 Fax: (03) 9257 0112 Email: fpv@fpv.org.au

Carlton

Melbourne Sexual Health Centre 580 Swanston Street, Carlton Contact: (03) 9341 6200 Free call: 1800 032 017 Web: www.mshc.org.au

Melbourne

Red Aware Level 2 South Tower 485 la Trobe Street, Melbourne Contact: (03) 9670 6171 Email: resources@yeah.org.au Era Health 563 Bourke Street, Melbourne Contact: (03) 9944 6200 Fax: (03) 9944 6290 Email: info@erahealth.com.au

Richmond

Multicultural Health and Support Services (HIV, hepatitis C and sexually transmissible infections) 23 Lennox Street, Richmond. Telephone: (03) 9418 9929 Fax: (03) 9421 4662 Email: enquiries@ceh.org.au Go to: www.ceh.org.au/mhss.aspx

Southbank

Straight Arrow Suite 1, 111 Coventry Street, Southbank Contact: (03) 9863 9414 Fax: (03) 9863 9421 Email: information@straightarrows.org.au

South Yarra

Victorian AIDS Council 6 Claremont Street, South Yarra Contact: (03) 9865 6700 Fax: (03) 9826 2700 Email: enquiries@vac.org.au

St. Kilda

Royal District Nursing Services (RDNS) 31 Alma Road, St. Kilda Contact: 1300 33 44 55

Rural Services Geelong

Barwon Health – BRASH Clinic Outpatients Annexe, 66 Bellerine Street, Geelong Contact: (03) 4215 0000 Fax: (03) 4215 1378

Portland

Portland District Health Bentinck Street, Portland Contact: (03) 5521 0333 Fax: (03) 5521 0388

Warrnambool

Warrnambool Base Hospital Ryot Street, Warrnambool Contact: (03) 5563 1666 Fax: (03) 5563 1660

Hepatitis Infoline Call the Hepatitis Infoline to talk about: Information: We can answer questions and mail information to you. Support: We can provide support for a range of issues and concerns. Referral: We can refer you to other organisations and services. The Hepatitis Infoline is a free and confidential service for all Victorians. Hours Monday to Friday 9.00am â&#x20AC;&#x201C; 5.00pm

1800 703 003 Your donations make a difference! our donations help us to provide information, services, advocacy, resources and support for people affected by viral hepatitis, health professÂionals and members of the general public.

All donations of $2 or more are tax deductible. If you do not receive your receipt promptly, then please call Hepatitis Victoria on 03 9380 4644, or email: admin@hepvic.org.au

I would like to donate the following amount:

Please send my receipt to:

$20

$50

$100

$_____ (Your choice)

Name

I have enclosed my cheque/money order/cash or Please debit my credit card for $______ Type of card: Visa/MasterCard

Address

Suburb/City

Name on Card Card number:

Expiry Date

Postcode State Send to: Hepatitis Victoria Suite 5, 200 Sydney Road Brunswick, Victoria 3056