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Prevention, Testing and Diagnosis

​​Summary​

  • ​Hepatitis B is a vaccine-preventable disease. Individuals at risk of exposure should be vaccinated.
  • Close to half of those living with hepatitis B are undiagnosed and therefore at risk of poor health outcomes.
  • Opportunistic testing for hepatitis B in priority populations presents an opportunity to diagnose, intervene and prevent illness and death.

Quick Facts

  • Only 56% of the estimated 218,000 people living with chronic hepatitis B are believed to have been diagnosed.1
  • Those born overseas and Aboriginal and Torres Strait Islander people comprise around two-thirds of all Australians living with CHB.1
  • A higher prevalence of CHB infection is also observed in people who inject drugs and in men who have sex with men.

Prevention

Immunisation is provided free of charge, for people at risk, by a number of state and territory governments. The vaccine  can be ordered by GPs through your health department.

Provisions vary according to jurisdiction and risk group. 

Testing

 Opportunistic testing presents an opportunity to diagnose, intervene and prevent illness and death. 

Opportunistic testing for hepatitis B, in a patient from a hepatitis B priority population, aligns with the screening provisions of the Medicare Benefits Schedule2   

When testing for hepatitis B, the tests to be ordered are: 

  • Hepatitis B surface antigen (HBsAg), 
  • Antibody to surface antigen (anti-HBs), and 
  • Antibody to core antigen (anti-HBc). 

Diagnosis

  • Positive HBsAg indicates current infection. 
  • Positive anti-HBs indicates immunity (through vaccination or past infection).
  • Positive anti-HBc indicates past or current infection (this test may occasionally give a false-positive result).
  • For interpretation of who and how to test and interpretation of serology information see the B Positive Website​ or the Decision Making in HBV tool.

 National Hepatitis B Strategy Targets

 ​​The National Hepatitis B Strategy 2014-2017​ set the following targets to be met by 2017:

  • Achieve HBV childhood vaccination coverage of 95%
  • Increase to 80% the proportion of all people living with chronic hepatitis B who are diagnosed.
  • Increase hepatitis B vaccination coverage of priority populations

Testing Portal and Hepatitis B Testing Policy

ASHM plays an important role in the National Hepatitis B Testing Policy development. ASHM facilitates the ongoing review of the National Hepatitis B Testing Policy and manages National Testing Portal. The portal covers HIV, HBV and HCV testing. Each policy is guided by an Expert Reference Group.

Resources​

ASHM develops a comprehensive range of practical resources to support the health professionals working with hepatitis B, as well as a series of profession-based booklets for groups most in contact with BBVs and STIs.  The resources focus on prevention, testing, diagnosis, management and treatment and are available in printed and/or online formats. 

All resources provided by ASHM are available at no cost, other than postage where required.

Education

ASHM develops and delivers national training curricula, face-to-face and online training, as well as webinars that cover prevention, testing and diagnosis. ​

National Laboratories: Best Practice Testing and Reporting of Test Results

Interpreting Hepatitis B Serology: Recommended wording for national laboratories to report hepatitis B diagnostic test results

This is a document designed for laboratories performing hepatitis B testing.

Its aim is to promote best practice testing and reporting of test results. This is in order to provide requesting doctors with a better understanding and interpretation of hepatitis serology, which can be confusing. The ultimate aim is to improve diagnosis and management of hepatitis B infection.

Download 

Policy development

As a professional organisation, ASHM has an active program of policy development.

ASHM contributes to policy, standards and the development of guidelines in the testing area.

 

​​​​References

  1. MacLachlan JH, Allard N, Towell V, Cowie BC. The burden of chronic hepatitis B virus infection in Australia, 2011. Aust N Z J Public Health 2013;37(5):416-22.
  2. Medicare Benefits Schedule (MBS). MBS – Note G13.1. 2012​

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