Rural and remote patients at the Royal Perth Hospital were reviewed and treated for hepatitis C by a hepatologist and nurse practitioner using telehealth (videoconferencing). Over a four-year period, 50 patients were treated with pegylated interferon and ribavirin, and participated in a total of more than 500 telehealth sessions. Sustained virological response rates (SVRs) were compared to those in face-to-face (FTF) clinics to assess treatment outcomes. Treatment through telehealth was found to be non-inferior to FTF clinics. Telehealth patients with genotype 1 infection achieved a higher rate of SVR than those attending FTF clinics (73% versus 54%, respectively), although the difference was not significant. SVR rates for genotype 2 and 3 of 72% were similar in telehealth to FTF rates of 74%. A total of 35 telehealth patients completed a satisfaction questionnaire and most indicated that they were happy with the programme and would participate again in the future. The study confirmed that telehealth is an effective option for the treatment of hepatitis C in rural and remote areas.

Pegylated interferon alpha, female sex and Asian ethnicity are independent risk factors for TD. Thyroid peroxidase antibodies and earlier TD within the course of IFN are associated with the requirement for treatment. Thyroid function tests should be monitored during and after IFN-based therapy. The most common cytological finding is a benign follicular pattern.

The aim of this study is to examine the acceptability and effectiveness of a nurse‐led hepatocellular carcinoma (HCC) surveillance clinic in high‐risk patients with cirrhosis/advanced fibrosis. Early detection of HCC is associated with better treatment outcomes and improved survival. International guidelines recommend 6‐monthly surveillance of patients at risk of developing HCC. A nurse‐led HCC surveillance protocol was established to support patients in adherence to surveillance protocols. The design used was retrospective document analysis. Retrospective analysis of healthcare records of patients referred to the clinic between August 2009 and December 2015. Extracted data included attendance of clinic visits, blood testing, ultrasound or other imaging, and outcomes. Ultrasound was attended within 6 months in 30.3% of cases and within 7 months in 71.2% of cases. The median time between Nurse‐Led Clinic appointments, ultrasound scans and blood testing did not exceed 9 months. First year FibroScans were attended by 82.9% (63/76) patients; endoscopy was indicated for 42 and attended by 35 (83.3%) patients. Lesions were identified in 16 patients (21.5%) and HCC diagnosed in two patients. One patient died because of HCC and one to sub‐dural haematoma. Nurse‐led HCC surveillance was an effective method of monitoring patients with cirrhosis at high risk of developing HCC. Well‐defined protocols enable timely identification of patients with HCC or hepatic decompensation so that management strategies can be implemented without delay. The potential benefits identified by this study warrant further, rigorous evaluation.

In this large real-world cohort of HCV genotype 1 subjects, treatment with PrOD was highly effective and similar to clinical trials. Important determinants of reduced SVR include early cessation of therapy and baseline bilirubin concentration. SAEs were not infrequent with CTP B patients being at greatest risk.