Hepatitis BRecommend hepatitis B vaccinations to all patients on the methadone program who are found to have no immunity to the hepatitis B virus.
Patients who are acutely infected or who are chronic carriers of hepatitis B should be referred to a gastroenterologist for special assessment and follow-up.
Hepatitis CA high percentage of patients entering methadone programs will be hepatitis C antibody positive.
Patients should be treated in accordance with Hepatitis C, A Management Guide for General Practitioners (RACGP 1999).
- Patients who are hepatitis C antibody positive but who have 3 normal serum aminotransferases (ALT and AST) over 6 months should have liver function tests repeated at 6 monthly intervals and a Hepatitis C polymerase chain reaction test at 12 months.
- If the patient has 3 abnormal serum aminotransferases over 6 months referral to a gastroenterologist or liver clinic for specialist assessment and shared care is indicated.