15 April 2019
Australian recommendations for the management of hepatitis B during cancer therapy were released today by Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, in partnership with the Australasian Society for Infectious Diseases, the Gastroenterological Society of Australia, the Haematology Society of Australia and New Zealand, and the Medical Oncology Group of Australia.
This Australian consensus statement was developed to simplify the approach to testing and prophylaxis for HBV during cancer therapy including medical specialists in infectious diseases, hepatology, haematology, oncology and paediatrics.
Approximately 240,000 Australians are living with hepatitis B virus infection, and approximately 2.3 million Australians have been exposed or infected in the past. Individuals with current or hepatitis B are at risk of the virus reactivation during cancer therapy. Reactivation can lead to liver failure, death or cancer treatment interruption that reduces cancer survival. Given the number of people undergoing cancer therapy and the burden of hepatitis B in Australia, several thousand people are likely to be at risk of hepatitis B reactivation each year.
Alexis Apostolellis, CEO of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine said, “All patients scheduled to undergo cancer treatment should be tested for hepatitis B, to avoid potentially life-threatening complications. Appropriate monitoring tests should also be subsidised to support appropriate clinical decision making, which may require changes to the number of HBV DNA tests rebated through Medicare.”
Dr Joseph Doyle from the Australasian Society for Infectious Diseases chaired the guidelines steering committee. Dr Doyle said, “Given this national approach is recommended for all cancer patients, we encourage the Pharmaceutical Benefits Scheme (PBS) to subsidise the cost of hepatitis B antiviral agents during cancer therapy.”
Dr Doyle said: “The Medicare Benefits Schedule (MBS) should include rebates for hepatitis B virus testing during and after cancer therapy, in accordance with these recommendations.
“We urge health care services and specialists to develop systems to implement these best practice recommendations.”
The consensus statement can be found at here, or through the ASHM HBV Resources page.