Hepatitis B and C

This guideline aims to get us to increase testing and identification. A lot of the risk factors are fairly obvious, but it is certainly not something I had previously been thinking about testing for outside of an antenatal or GUM scenario. My advice is that if you are thinking of testing for Hep B / C, also consider if HIV testing is worth doing (remember recent NICE guidance). My advice is also to remember that you don't have to do any lengthy counselling with patients before testing - just let them know what you are testing for and why.

Ask about risk factors:

  • On new registration
  • Men who have sex with men
  • Antenatal presentations

Offer testing to adults and children at presentation or on registration to:

  • Migrants from medium or high prevalence countries (Africa, Asia, the Caribbean, Central and South America, Eastern and Southern Europe, the Middle East and the Pacific islands).
  • People who have ever injected drugs (including performance enhancing or steroid drugs).
  • Men who have sex with men.
  • Anyone who has had unprotected sex (especially with multiple partners, in areas of higher prevalence, commercial sex workers, if attending GUM clinics and if testing positive for other STDs).
  • Looked after children.
  • Prisoners
  • Immigration detainees
  • Close contacts of those with Chronic Hep B or C
  • Babies of mothers with Hep B or C
  • People on hostels or the homeless
  • People who received a blood transfusion before 1991 or blood products
    before 1986.

Annual Hepatitis C testing should be offered to:

  • All who test negative and remain at risk.

Offer Hepatitis B vaccination to:

  • Men who have sex with men who are offered HIV testing.
  • People who test negative but remain at high risk.

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton.

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