182810 - check, unit 564, Liver problems, September 2019

This edition of check focuses on the assessment and management of liver problems in general practice.

Liver disease accounted for 1204 premature deaths in Australia in 2012 and was determined to be the eleventh leading cause of early death in 2010–12.(1) GPs are ideally placed to recognise early signs of liver disease to decrease the risk of outcomes such as cirrhosis and liver cancer.
In 2017 it was estimated that 233,947 people in Australia were living with chronic hepatitis B virus (HBV) infection, although almost 40% of these cases were thought to be undiagnosed.(2)
Cirrhosis develops in 15–25% of patients with chronic HBV infection.(3)
Figures for hepatitis C virus (HCV) are similar, with the prevalence of chronic HCV in early 2016 estimated to be 227,306.(2) Although 20–30% of people with HCV develop cirrhosis,(4) the high cure rates associated with direct-acting antiviral therapy highlight the importance of early detection and treatment.(2)
References on file.

D1. Communication skills and the patient-doctor relationship

D2. Applied professional knowledge and skills

• Continuity of care promotes quality and safety

D3. Population health and the context of general practice

• The patterns and prevalence of disease are incorporated into screening and management practices

D4. Professional and ethical role

D5. Organisational and legal dimensions

• Adult health