British Association for the study of the Liver
Action Planned
The British Association for the Study of the Liver (BASL) clarifies it does not develop clinical guidelines. It plans to incorporate hepatitis B reactivation risks and prevention into its webinar and conference programmes in the coming year to highlight gaps in monitoring and prescribing. (AI summary)
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Dear Mr Brittain,
Re: Prevention of Future Deaths Report
The British Viral Hepatitis Group (BVHG) is a sub-group of the British Association for the Study of the Liver (BASL). BASL is a charitable specialist society dedicated to advancing knowledge and understanding of liver diseases and to the optimal care of patients with those diseases. These aims are principally achieved through dissemination of research and sharing of clinical expertise and through the promotion of opportunities for collaboration in liver research. BASL does not lead the development or publication of clinical guidelines.
There are two groups of patients requiring antiviral therapy when undergoing immunosuppressive treatment:
• The first is those patients with a diagnosis of chronic hepatitis B (CHB) defined by the presence of a positive hepatitis B surface antigen (HBsAg) on two occasions 6 months apart. These CHB patients are usually managed in specialist hepatology services and the responsibility of monitoring and prescribing lies with these services.
• The second group is those patients who are HBsAg negative but hepatitis B core antibody (HBcAb) positive. These patients are at risk of hepatitis B reactivation in the setting of immunosuppressive treatment. There are many different specialties who prescribe immunosuppressive regimens, including (but not limited to) haematology, oncology, and non-liver organ transplant services. Guidance regarding the need for antiviral therapy for such patients is provided by the relevant specialist societies and frequently also in local NHS Trust guidance. There is variation between NHS Trusts as to whether this monitoring and prescribing is delivered by the treating team or whether specialist hepatology services are involved.
The British Association for the Study of the Liver (BASL) Secretariat Office c/o Executive Business Support Ltd Stowe House, St Chad’s Road, Lichfield, Staffordshire WS13 6TJ
Limited Company No: 5017662. Registered Charity No: 1106320
• In line with the educational role of BASL and BVHG we have previously and will again incorporate the risks of hepatitis B reactivation and its prevention and management into our webinar and conference programmes in this coming year. We will use this forum to highlight the risks of gaps in monitoring and prescribing of antiviral treatment for participants to take back to their local services.
Additionally, we will continue to highlight the role of health inequalities and access to care that also appears to have impacted the outcome in this case as we recognise these as being major issues for people living with viral hepatitis infections more widely.
Re: Prevention of Future Deaths Report
The British Viral Hepatitis Group (BVHG) is a sub-group of the British Association for the Study of the Liver (BASL). BASL is a charitable specialist society dedicated to advancing knowledge and understanding of liver diseases and to the optimal care of patients with those diseases. These aims are principally achieved through dissemination of research and sharing of clinical expertise and through the promotion of opportunities for collaboration in liver research. BASL does not lead the development or publication of clinical guidelines.
There are two groups of patients requiring antiviral therapy when undergoing immunosuppressive treatment:
• The first is those patients with a diagnosis of chronic hepatitis B (CHB) defined by the presence of a positive hepatitis B surface antigen (HBsAg) on two occasions 6 months apart. These CHB patients are usually managed in specialist hepatology services and the responsibility of monitoring and prescribing lies with these services.
• The second group is those patients who are HBsAg negative but hepatitis B core antibody (HBcAb) positive. These patients are at risk of hepatitis B reactivation in the setting of immunosuppressive treatment. There are many different specialties who prescribe immunosuppressive regimens, including (but not limited to) haematology, oncology, and non-liver organ transplant services. Guidance regarding the need for antiviral therapy for such patients is provided by the relevant specialist societies and frequently also in local NHS Trust guidance. There is variation between NHS Trusts as to whether this monitoring and prescribing is delivered by the treating team or whether specialist hepatology services are involved.
The British Association for the Study of the Liver (BASL) Secretariat Office c/o Executive Business Support Ltd Stowe House, St Chad’s Road, Lichfield, Staffordshire WS13 6TJ
Limited Company No: 5017662. Registered Charity No: 1106320
• In line with the educational role of BASL and BVHG we have previously and will again incorporate the risks of hepatitis B reactivation and its prevention and management into our webinar and conference programmes in this coming year. We will use this forum to highlight the risks of gaps in monitoring and prescribing of antiviral treatment for participants to take back to their local services.
Additionally, we will continue to highlight the role of health inequalities and access to care that also appears to have impacted the outcome in this case as we recognise these as being major issues for people living with viral hepatitis infections more widely.