Hepatitis B is a blood-borne and sexually transmitted viral infection. The virus is transmitted either through percutaneous (puncture of skin) or mucosal exposure to contaminated blood or body fluids. Serum, semen and saliva can be infectious for hepatitis B. The liver is the major site of hepatitis B viral replication.
Hepatitis B transmission occurs:
- from mother to infant at or around birth (perinatal)
- between children
- in household settings between children and adults
- through sexual contact
- in healthcare settings, including from exposure to contaminated equipment, blood products and body tissues or fluids
- through the unsafe sharing of injecting equipment.
The number of people living with chronic hepatitis B in Australia was estimated in 2000 to be between 90 000 and 160 000, representing a prevalence rate of 0.5% to 0.8%.2 The authors of this study support a national blood survey to resolve uncertainty in these estimates. A more recent survey estimates the range between 153 000 and 175 000 of people living with chronic hepatitis B.3, 4 In 2008, 245 and 6600 notifications of hepatitis B (unspecified) were reported to the Australian Government’s National Notifiable Diseases Surveillance System.
By 2017, it is estimated there will be a two- to three-fold increase in the number of hepatitis B-induced liver cancer cases and a marked increase in the number of deaths attributable to hepatitis B under current treatment patterns.5
The major issues relating to hepatitis B in Australia are, and will remain, the need to prevent new infection and manage established chronic infection. This strategy provides guidance on the development of activities needed to identify and manage undiagnosed (and therefore unmanaged) cases of hepatitis B. New infections in adults rarely lead to chronic infection and vaccination programs will largely prevent domestic acquisition in the longer term.
Australia has reduced the impact of hepatitis B by: securing a safe blood supply; implementing a national hepatitis B immunisation program; and providing treatment for people with chronic hepatitis B through the Pharmaceutical Benefits Scheme. The National Hepatitis B Strategy 2010–2013 broadens this approach by promoting comprehensive and inclusive strategies. The involvement of communities most affected by hepatitis B is essential to all levels of the national response.
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1 Lavanchy D, ‘Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures’, Journal of Viral Hepatitis, 2004, issue11 (2): pp. 97–101.
2 O’Sullivan B, Gidding H. Law M, Kaldor J, Gilbert G & Dore G ‘Estimates of chronic hepatitis B virus infection in Australia’, 2000, Australian and New Zealand Journal of Public Health, 2004, vol 28; pp. 212–26.
3 Gidding H, Warlow M, MacIntyre C, Bakehouse J, Gilbert G, Quinn H & McIntyre P, ‘The impact of a new universal infant and school-based adolescent hepatitis B vaccination program in Australia’, Vaccine, 2007, issue 25 (51): pp. 8637–41.
4 The Ottawa Charter for Health Promotion is a 1986 document produced by the World Health Organization. It was launched at the first international conference for health promotion that was held in Ottawa, Canada.
5 Homewood J, Coory M & Dinh B ‘Cancer among people living in rural and remote indigenous communities in Queensland: an update 1997–2002’, Queensland Health, 2005