Abdul Mannan: Breaking Down the New BSH Hepatitis Guideline for Haemophilia Nurses
Abdul Mannan, Consultant Haematologist, Director Haemophilia Centre, Haematology Lab Lead at Betsi Cadwaladr University Health Board shared a post on LinkedIn:
”Haemophilia nurses asked me to explain the new BSH hepatitis guideline. It’s 9 pages of dense clinical recommendations.
So I broke it down.
The guideline addresses a painful reality. Over 2,295 people with bleeding disorders in the UK were infected with hepatitis C through contaminated blood products in the 1970s-1990s. Many are our patients today.
I created a simplified learning resource for Band 7 nurses covering what they actually need to do:
Who to screen: anyone who received blood/plasma products before 1996
What tests to order: HBsAg, anti-HBs, anti-HBc, HCV antibody, and reflex HCV-RNA if positive
When to refer: active HBV/HCV infection goes straight to hepatology, F3/F4 fibrosis needs surveillance discussion
How to assess fibrosis: FibroScan is best, but FIB-4 score works if imaging isn’t available
The trickiest part? Deciding who needs long-term HCC surveillance after HCV treatment. The guideline gives clear pathways based on historical fibrosis staging.
I included worked examples, practical scenarios, and a step-by-step walkthrough of the follow-up algorithm. Clinical guidelines work better when nurses can actually use them.
Published in British Journal of Haematology, January 2025․՛
Access the full learning resource here: Hepatitis B & C Management in Bleeding Disorders – A Learning Resource for Haemophilia Nurses․”
Title: Guideline for the management of hepatitis B and C infection and subsequent liver disease surveillance (where indicated) in people with congenital bleeding disorders: A joint guideline from the British Society of Haematology and the British Viral Hepatitis Group
Authors: Ashley Brown, Richard J. Aspinall, Stephen T. Barclay, Mark Gillyon-Powell, Katie Jeffery, Patrick T. Kennedy, Neil McDougall, Tom Pembroke, Martin Scott, Susan Shapiro
Read the Full Article on British Journal of Haematology.
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