Direct to an emergency department for:
- Acute liver failure
- Sepsis in a patient with cirrhosis
- Severe hepatic encephalopathy
- Severe ascites restricting movement and breathing.
Criteria for referral to public hospital specialist clinic services
- Patients who are hepatitis C (HCV) RNA positive unable to be managed and treated in community-based services.
Information to be included in the referral
Information that must be provided
- Hepatitis C virus serology, genotype and RNA results
- Hepatitis B virus serology results
- HIV serology results
- Liver function tests including aspartate transaminase (AST)
- Full blood examination
- Upper abdominal ultrasound results
- If pregnant, gestational age
- Current and complete medication history (including non-prescription medicines, herbs and supplements).
Provide if available
- Previous liver biopsy results
- Details of previous medical management including the course of treatment and outcome of treatment
- History of alcohol intake
- History of injectable drug use, including if the patient is still injecting.
The Summary and referral information lists the information that should be included in a referral request.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- Hepatitis C should managed and treated through suitable community-based services wherever possible
- Patients who are hepatitis C (HCV) RNA negative who are not at ongoing risk of cirrhosis.