National Hepatitis B Strategy 2010–2013

5. Priority populations

Page last updated: July 2010

Unlike hepatitis C, HIV and the STIs predominantly addressed in this suite of strategies, hepatitis B can be prevented by vaccine. The vaccine prevents new infections, particularly important in newborns and children as they have a greater risk of adverse events and disease progression if infected with hepatitis B. The importance of childhood vaccination is recognised by its inclusion in the National Immunisation Program Schedule. Activities that aim to reduce the burden of disease for those with existing chronic infection are also discussed in this strategy.

The greatest burden of hepatitis B is borne by those who already have hepatitis B infection (chronic infection), many of whom were infected at birth or as children and who may be unaware of their infection. As a result, this strategy explores priorities relating to the detection and subsequent management of chronic hepatitis B.

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Prevention of hepatitis B transmission

This strategy covers the prevention of hepatitis B transmission in three priority
populations:
  1. people from Culturally and Linguistically Diverse (CALD) backgrounds
  2. Aboriginal and Torres Strait Islander peoples
  3. children born to mothers with chronic hepatitis B (pregnant women).
It also covers these other four main populations of interest:
  • unvaccinated adults at higher risk of infection specifically:
    • men who have sex with men
    • sex workers
    • people who inject drugs
    • partners and other household and intimate contacts of people who have chronic hepatitis B infection
    • people in custodial settings
    • people with human immunodeficiency virus (HIV) or hepatitis C, or both
  • healthcare workers and emergency services workers
  • people travelling to and from high prevalence countries, particularly those visiting families and friends in their country of origin
  • vulnerable populations, including the homeless and people with mental health issues.

Monitoring, detecting and treating chronic hepatitis B

This strategy also covers monitoring, detecting and treating chronic hepatitis B in two priority populations:
  • people from CALD backgrounds
  • Aboriginal and Torres Strait Islander peoples.
All people with chronic hepatitis B require monitoring to determine if treatment is required and to detect early signs of related liver disease. People at risk of, or people who have, chronic hepatitis B often come from a diverse cross-section of ethnic and social backgrounds. Hepatitis B infection often exists in communities that have less access to general health services, such as in Aboriginal and Torres Strait Islander communities.

The migration patterns in Australia and also the variation in the infrastructure available for specific communities means that interventions for these communities must occur at local level. The implementation plan for this strategy takes these variations into account.

There is a need to ensure that the specific population groups most affected by chronic hepatitis B are not stigmatised through being identified or named. This is important so that the individuals within these groups are not reluctant to access healthcare and consequently increase the burden of chronic hepatitis B on the Australian community.

The remainder of this chapter provides further information about this strategy’s priority populations—for both the prevention of hepatitis B transmission and for monitoring, detecting and treating chronic hepatitis B.