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Disease WAtch

Australia adopts policy on testing for hepatitis B virus

Hepatitis B virus (HBV) infection is a major public health issue in Australia. An estimated 170,000 people in Australia are infected with hepatitis B and many more have been exposed to the virus1.

The impact of this disease is — and will continue to be — significant as the prevalence of HBV-related cirrhosis and hepatocellular carcinoma (HCC) continue to rise2. The majority of newly reported infections in Australia are chronic (of more than 6 months’ duration), occurring in people who have been infected at birth or during childhood in high-prevalence countries.

The National HBV Testing Policy is the first testing policy for this disease to be adopted in Australia. The purpose of the policy is to define appropriate testing pathways using currently available technologies. The policy is relevant for all health professionals ordering and interpreting tests for hepatitis B. The policy is not intended to be a resource for people with — or at risk of — hepatitis B.

The two priority populations for hepatitis B testing, as identified in the policy, are:

  • adults and children from culturally and linguistically diverse (CALD) backgrounds, particularly those born in countries of intermediate and high HBV prevalence
  • Aboriginal and Torres Strait Islander people.

Appropriate HBV testing will show whether an exposed individual has cleared the virus spontaneously or has become acutely or chronically infected.

Testing can also determine how advanced the infection is and assist with timing the start of anti-viral therapy. HBV infection can lead to cirrhosis and/or liver cancer (in up to 25% of people with chronic hepatitis B). Ongoing monitoring and timely treatment can help delay the onset of serious liver disease or liver cancer.

The policy contains information about principles of hepatitis B testing, diagnostic strategies, indications for testing, obtaining informed consent and conveying test results. Details about hepatitis B testing and the Medicare Benefits Schedule are also included.

A recent Disease WAtch article on Interpreting hepatitis B serology included a summary of components of hepatitis B serology.

Free online education material about hepatitis B and C is available for health professionals.

References

  1. www.med.unsw.edu.au/NCHECRweb.nsf/resources/2011/$file/KIRBY_ASR2011.pdf
  2. www.aihw.gov.au/publication-detail/?id=10737421461&tab=2

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