Porphyria cutanea tarda — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 69 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting porphyria cutanea tarda or death from porphyria cutanea tarda with the circumstances of a person's relevant service:

1. (1)
   for males, consuming a total of at least 100 kilograms of alcohol within the 10 years before the clinical onset of porphyria cutanea tarda;

   Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

2. (2)
   for females, consuming a total of at least 50 kilograms of alcohol within the 10 years before the clinical onset of porphyria cutanea tarda;

   Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

3. (3)
   having alcohol use disorder at the time of the clinical onset of porphyria cutanea tarda;
4. (4)
   having cirrhosis of the liver or steatohepatitis at the time of the clinical onset of porphyria cutanea tarda;
5. (5)
   having chronic renal failure at the time of the clinical onset of porphyria cutanea tarda;

   Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

6. (6)
   having hepatic iron overload at the time of the clinical onset of porphyria cutanea tarda;

   Note: iron overload is defined in the Schedule 1 - Dictionary.

7. (7)
   having a viral infection from the specified list of viral infections at the time of the clinical onset of porphyria cutanea tarda;

   Note: specified list of viral infections is defined in the Schedule 1 - Dictionary.

8. (8)
   taking a drug from the specified list of drugs within the 30 days before the clinical onset of porphyria cutanea tarda;

   Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

9. (9)
   taking a drug which is associated in the individual with the clinical onset of porphyria cutanea tarda during drug therapy and either: (a) the improvement of porphyria cutanea tarda within 2 months of discontinuing or tapering drug therapy; or (b) the redevelopment of porphyria cutanea tarda on rechallenge with the same drug; and where taking the drug continued for at least the 7 days before the clinical onset of porphyria cutanea tarda;
10. (10)
    inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) within the 1 year before the clinical onset of porphyria cutanea tarda;

    Note: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.

11. (11)
    ingesting food contaminated with hexachlorobenzene within the 1 year before the clinical onset of porphyria cutanea tarda;
12. (12)
    having smoked tobacco products: (a) in an amount of at least 10 cigarettes per day or the equivalent thereof in other tobacco products; and (b) for at least the 6 months before the clinical onset of porphyria cutanea tarda; and if smoking has ceased before the clinical onset of porphyria cutanea tarda, then that onset occurred within 30 days of cessation;

    Note: cigarettes per day or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

13. (13)
    for males, consuming a total of at least 100 kilograms of alcohol within the 10 years before the clinical worsening of porphyria cutanea tarda;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

14. (14)
    for females, consuming a total of at least 50 kilograms of alcohol within the 10 years before the clinical worsening of porphyria cutanea tarda;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

15. (15)
    having alcohol use disorder at the time of the clinical worsening of porphyria cutanea tarda;
16. (16)
    having cirrhosis of the liver or steatohepatitis at the time of the clinical worsening of porphyria cutanea tarda;
17. (17)
    having chronic renal failure at the time of the clinical worsening of porphyria cutanea tarda;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

18. (18)
    having hepatic iron overload at the time of the clinical worsening of porphyria cutanea tarda;

    Note: iron overload is defined in the Schedule 1 - Dictionary.

19. (19)
    having a viral infection from the specified list of viral infections at the time of the clinical worsening of porphyria cutanea tarda;

    Note: specified list of viral infections is defined in the Schedule 1 - Dictionary.

20. (20)
    taking a drug from the specified list of drugs within the 30 days before the clinical worsening of porphyria cutanea tarda;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

21. (21)
    taking a drug which is associated in the individual with: (a) the clinical worsening of porphyria cutanea tarda during drug therapy; and (b) the improvement of porphyria cutanea tarda within 2 months of discontinuing or tapering drug therapy; and where taking the drug continued for at least the 7 days before the clinical worsening of porphyria cutanea tarda;
22. (22)
    inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) within the 1 year before the clinical worsening of porphyria cutanea tarda;

    Note: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.

23. (23)
    ingesting food contaminated with hexachlorobenzene within the 1 year before the clinical worsening of porphyria cutanea tarda;
24. (24)
    having smoked tobacco products: (a) in an amount of at least 10 cigarettes per day or the equivalent thereof in other tobacco products; and (b) for least 6 months before the clinical worsening of porphyria cutanea tarda; and if smoking has ceased before the clinical worsening of porphyria cutanea tarda, then that worsening occurred within 30 days of cessation;

    Note: cigarettes per day or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

25. (25)
    inability to obtain appropriate clinical management for porphyria cutanea tarda;

Aggravation-only factors: the factors in subsections 9(13) to 9(25) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.