When should I consider referring a patient with Hepatitis C for specialist care?

Consider referring a patient with hepatitis C for specialist care in the following situations:

• If acute hepatitis C virus (HCV) infection is suspected (hepatitis C antibody positive with clinical features of acute hepatitis and/or a likely recent source of transmission), arrange a same-day assessment or seek immediate specialist advice.
• If chronic HCV infection is suspected (hepatitis C antibody positive and ribonucleic acid positive with no clinical features of acute hepatitis), arrange an urgent referral to a hepatologist or specialist gastroenterologist.
• All people identified as positive for HCV infection should be referred for specialist assessment regardless of treatment candidacy.
• People with chronic hepatitis C infection undergoing specialist treatment should remain under specialist care for ongoing monitoring and management.
• Referral is also indicated for assessment of liver disease progression, including screening for hepatocellular carcinoma and evaluation of fibrosis or cirrhosis.

Specialist care is essential to initiate antiviral treatment, monitor for complications, and provide education and support to reduce disease progression and transmission risk.

Ensure to notify the local Health Protection Team of suspected acute viral hepatitis cases immediately and provide baseline investigations while awaiting specialist management.

Referral should be prompt to optimise treatment outcomes and reduce the risk of complications such as end-stage liver disease and hepatocellular cancer.

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