Sector Release

Australia, 28 July 2017

With the availability of effective vaccines and treatments for hepatitis B and a cure for hepatitis C, the elimination of viral hepatitis is achievable and this is the theme of World Hepatitis Day 2017. With close to half a million Australians living with chronic hepatitis B and C, it is vital for primary care providers to know the risk factors, test and diagnose people living with hepatitis, to enable management and treatment to start early enough to halt serious liver damage.

 

What is World Hepatitis Day?

World Hepatitis Day (WHD) takes places every year on 28 July, one of just four disease-specific global awareness days officially endorsed by the World Health Organization (WHO). Viral hepatitis is one of the leading causes of death globally, accounting for 1.34 million deaths per year – that’s as many as HIV/AIDS, tuberculosis or malaria. Together, hepatitis B virus and hepatitis C cause 80% of liver cancer cases in the world. Liver cancer is the fastest-growing cause of cancer death in Australia [1]. More than 1,400 Australians die from liver cancer each year and a third of those diagnosed die within a month of diagnosis [2].

 

Hepatitis B in Australia

All health care providers have an essential role to play in the testing, diagnosis and management of people living with chronic hepatitis B (CHB). It is estimated that more than 90,000 Australians are living with undiagnosed chronic hepatitis B (CHB). Furthermore less than half of the people who need antiviral treatment are receiving it [3].

There are 380 deaths attributable to hepatitis B each year.

Timely diagnosis and clinical management, including antiviral therapy, can prevent CHB-related deaths from cirrhosis and liver cancer.

 

How primary care providers can make a difference

  • Opportunistically test people from priority populations for hepatitis B.
  • Correctly monitor people with CHB to assess for phase of disease, and manage or refer accordingly.
  • Identify when a patient should be referred for consideration of treatment.
  • Test and vaccinate family members, household contacts and sexual contacts of people with hepatitis B.
  • Learn more: Find hepatitis B training near you, access resources or online learning
  • Become a HBV s100 Prescriber:  The hepatitis B prescriber program enables General Practitioners to prescribe Highly Specialised Drugs for the treatment of chronic hepatitis B.

 

Hepatitis C in Australia

Hepatitis C can be cured. New Direct Acting Antiviral (DAA) medications available on the Australian Pharmaceutical Benefits Scheme (PBS) from 1 March 2016 are associated with average cure rates of >90%. They are well tolerated, shorter duration and orally administered. Everyone living with chronic HCV infection should be considered for antiviral treatment. GPs are able to prescribe these regimens under the S85 General Schedule.

Hepatitis C virus (HCV) is one of the most commonly notified diseases in Australia. There are an estimated 230,000 people living with chronic HCV, including 58,000 with moderate to severe liver disease. Curing hepatitis C substantially reduces the risk of liver cancer and liver failure, reducing mortality from cirrhosis and liver cancer. [4] It can also improve quality of life, including physical, emotional, and social health. [6]

 

How primary care providers can make a difference

 

Further Information

Watch Interventions to Enhance Hep B Cascade

The largest gap in the cascade of care is between diagnosis and engagement in ongoing care. Engaging people living with chronic hepatitis B in ongoing monitoring is critical. Learn more about the hepatitis B cascade of care watch the 2016 Australasian Viral Hepatitis Conference presentation from Jennifer MacLachlan on Interventions to Enhance Hep B Cascade

 

Watch Curing HCV – Leave no patient behind

People requiring treatments are not going to come to the tertiary hospitals. Treatment needs to be provided in the places that are acceptable and accessible to those who are at most risk, to the people who are most affected. Watch the 2016 Australasian Viral Hepatitis Conference presentation from Simone Strasser on Curing HCV - Leave no Patient Behind

 

Watch Curing Hepatitis C in General Practice: The First 60 Days

All clinicians with the skills and experience to manage HCV can initiate treatment for hepatitis C and cure their patients.  Watch the 2016 Australasian Viral Hepatitis Conference presentation from David Baker as he recalls on Curing Hepatitis C in General Practice: The First 60 Days

 

Attend the 2017 Australasian Viral Hepatitis Elimination Conference

The AVHEC brings together policy makers, researchers, primary health care providers, community-service providers and other individuals committed towards the virtual hepatitis elimination. Join a program that will present latest scientific developments and knowledge, and offer opportunities for structured dialogue assessing where we are, evaluating lessons learnt, in discussing our major issues towards charting the Australasian response to Viral Hepatitis.

 

References

  1. MachLachlan JH, Cowrie BC. Liver cancer is the fastest increasing cause of cancer death in Australians. Med J Australia 2012; 197(9): 492-3.
  2. Carville KS, MacLachlan JH, Cowrie BC. Liver cancer in Victoria, 1982-2007: epidemiological determinants and secular and geographic trends. North Melbourne: VIDRL, 2012.
  3. MacLachlan JH, Cowie BC and Haynes K. Hepatitis B Mapping Project: Estimates of chronic hepatitis B prevalence, diagnosis, monitoring and treatment by Primary Health Network, 2014/15 – National Report
  4. Hepatitis Australia. A guide to current and emerging hepatitis C treatments in Australia. 2012.
  5. MacLachlan JH, Cowie BC and Haynes K. Hepatitis B Mapping Project: Estimates of chronic hepatitis B prevalence, diagnosis, monitoring and treatment by Primary Health Network, 2014/15 – National Report
  6. Kirby Institute UNSW Hepatitis B and C in Australia Annual Surveillance Report Supplement