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Hepatitis – When to Refer

When to Refer

PLWHIV with liver disease who drink alcohol should be offered psychiatric, psychological, social and medical support to stop drinking.1

PLWHIV with cirrhosis should be managed in collaboration with experts in liver disease.1

  • Patients with cirrhosis should be referred for variceal assessment and have regular monitoring for hepatocellular carcinoma (HCC)1
  • Cirrhotic patients should be referred early for transplant assessment as the disease progresses rapidly.2 Indications for referral for liver transplantation include:1
    • decompensated cirrhosis (ascites, encephalopathy and/or variceal bleeding)
    • early HCC

All PLWHIV infected with HDV should be considered for early treatment by a physician with experience in this area.2


  1. European AIDS Clinical Society (EACS). Guidelines Version 6.0. Accessed 30 November 2011.
  2. BHIVA Viral Hepatitis Working Group. British HIV Association Guidelines for the Management of Coinfection with HIV-1 and Hepatitis B or C virus 2010. Accessed 1 December 2011.