Updated blood borne virus guidelines for health professionals in SA

SA Health, 11 April 2019

The ‘Australian National Guidelines for the Management of Healthcare Workers Living with Blood Borne Viruses and Healthcare Workers who Perform Exposure Prone Procedures at Risk of Exposure to Blood Borne Viruses’ have been updated. They can be viewed on the Commonwealth Department of Health website.

The guidelines are in two parts:

Part A provides information and recommendations for all healthcare workers, in particular:

  • healthcare workers who perform exposure prone procedures
  • healthcare workers living with a blood borne virus, and
  • doctors treating healthcare workers with a blood borne virus.

Part B provides information and recommendations for public health authorities including, but not limited to, hospitals and jurisdictional health departments, when managing or investigating a situation where a healthcare worker with a blood borne virus was not compliant with these guidelines and/or may have placed a patient(s) at risk of infection.

 

 

Surveillance of sexually transmitted infections and blood-borne viruses in South Australia, 2017

Communicable Disease Control Branch, SA Health, 2018

In 2017, there were 8,181 new notifications of STIs and BBVs in South Australia. This figure represents a 7% increase in the number of new notifications compared to notifications received in 2016, and a 14% increase compared to the five year average (2012-2016).

In 2017, there were 5,910 notifications of genital chlamydia making this the most commonly notified STI in South Australia.  The notification rate of chlamydia in 2017 was 343 per 100,000 population, and has been stable over the past five years.

There were no notifications of donovanosis in 2017.

There were 1,271 notifications of gonorrhoea in 2017. The notification rate of gonorrhoea increased from 45 per 100,000 population in 2014 to 74 per 100,000 population in 2017.

There were 158 notifications of infectious syphilis in 2017, the highest number of annual notifications in the past 10 years.

There were 60 new diagnoses of HIV infection in 2017. The notification rate of newly diagnosed HIV infection in 2017 was 3.5 per 100,000 population, above that in 2016 of 3.1 per 100,000 population. The notification rate in the Aboriginal population rose to 9.6 per 100,000 in 2017, up from 4.8 per 100,000 in 2016.

There were 11 notifications of newly acquired hepatitis B infection in 2017, above the five year average (2012-2016) of nine cases per year. There were 272 notifications of unspecified hepatitis B virus infection reported in 2017. The notification rate has declined in the Aboriginal population over the past five years.

There were 32 notifications of newly acquired hepatitis C in 2017. The majority of cases were males (75%). The notification rate of unspecified hepatitis C infection was 23 per 100,000 population in 2017.

There were 10 new diagnoses of hepatitis D infection in 2017, which is consistent with the five year average of 10 notifications per year.

 

 

 

 

Post Exposure Prophylaxis (PEP) for HIV: An overview for Health Professionals

SHINE SA, October 2018

Access to PEP after an eligible exposure to HIV is a medical emergency. Your response to patients presenting for PEP can support them in preventing a life-long infection with HIV.

A brief, online training module has been created to support health professionals to:

• Increase your understanding of PEP as an emergency presentation and vital HIV prevention measure
• Assist you in providing patients with optimal care and support when seeking PEP in the emergency setting

This course is designed for Medical Officers and Registered Nurses in hospital emergency departments and targeted primary care clinical and rural sites that hold PEP starter packs in South Australia.

  • To register for the free PEP training module, please email us here with your name, position and workplace.

SA Health has contributed funds towards this program.

HIV diagnoses hit seven year low: Australia’s annual HIV figures released

Kirby Institute, UNSW, Monday, 24 September 2018

Australia has recorded its lowest level of HIV diagnoses in seven years, according to a new report from the Kirby Institute at UNSW Sydney.

The report, released at the Australasian HIV&AIDS Conference in Sydney, found that there were 963 new HIV diagnoses in 2017, the lowest number since 2010.

Researchers are attributing the promising results to more people getting tested for HIV, more people living with HIV starting treatment which reduces the risk of HIV transmission to effectively zero, and an increased use of pre-exposure prophylaxis (or PrEP, an HIV prevention pill).

However, it is not all good news. According to the report, a quarter of new HIV diagnoses in 2017 were among heterosexuals, with a 10% increase in diagnoses over the past five years.

Among Aboriginal and Torres Strait Islander populations, HIV diagnoses have been increasing over the past five years, with rates almost two times higher than the Australian-born non-Indigenous population in 2017.

HIV incidence in Indigenous and non-Indigenous populations in Australia

The Lancet HIV: August 07, 2018

DOI: https://doi.org/10.1016/S2352-3018(18)30135-8

Ward, J ;McManus, H; McGregor, S;  et al.

Methods

Using the National HIV Registry at The Kirby Institute at UNSW, Sydney, NSW, Australia, we collated and analysed annual HIV notification data for 1996–2015. Patients who were not born in Australia were excluded. We calculated the rates of HIV diagnoses with annual trends in notification rates for Indigenous versus non-Indigenous Australians by demographic characteristics, exposure categories, and stage of HIV at diagnosis. For missing data, assumptions were made and verified through sensitivity analyses. Annual rate ratio (RR) and 4 year summary rate ratio (SRR) trends were calculated to determine patterns of HIV diagnosis in the two populations.

Findings

Between Jan 1, 1996, and Dec 31, 2015, 11 492 people born in Australia were reported with a diagnosis of HIV, of whom 461 (4%) were recorded as Indigenous Australians and we classified the remaining 11 031 (96%) as non-Indigenous Australians. For exposure to HIV, among Indigenous Australians a higher proportion of diagnoses occurred among women, and through injecting drug use and heterosexual sex than among non-Indigenous Australians (p<0·0001). Among Indigenous Australians, we found a significantly higher SRR of HIV diagnoses among men in the period 2012–15 than in previous periods (SRR 1·53, 95% CI 1·28–1·83; p<0·0001), and significantly higher diagnosis among Indigenous women (4·92, 4·02–6·02; p<0·0001) for the entire study period than among non-Indigenous women. Concurrently, a decrease in HIV diagnoses of 1% per annum (RR 0·99, 95% CI 0·98–0·99; p<0·0001) across the study period was seen among non-Indigenous people. Indigenous Australians were more likely to be diagnosed at an advanced stage of HIV infection than non-Indigenous Australians (20·8% vs 15·1%; p=0·0088).

Interpretation

Greater efforts should be made to include Indigenous people in prevention strategies, particularly newer biomedical interventions, such as scale up of pre-exposure prophylaxis and treatment as prevention initiatives in Australia. More involvement of Indigenous Australians in these approaches is also required to prevent widening of the gap in HIV diagnosis rates between non-Indigenous and Indigenous Australians.

 

Surgeon Who Was Denied Disability Insurance for Taking PrEP Tells His Story

Earlier this year, urology resident Dr. Philip Cheng appeared on the front page of the New York Times. Here was the headline: He Took a Drug to Prevent AIDS. Then He Couldn’t Get Disability Insurance.

The piece understandably drew widespread attention, with sharp disapproval of the denial from ID specialists and public health officials. We couldn’t understand why someone adopting the recommended strategy for HIV prevention was being penalized.

In this Open Forum Infectious Diseases podcast, he tells us some more about himself and the events surrounding his decision.