In contrast to Australia’s success with hepatitis C, our response to hepatitis B is lagging

The Conversation, October 15th, 2019

Around one-third of Australians living with hepatitis C have been cured in the last four years. Australia’s response to hepatitis C is seen as a leading example around the world, and the elimination of the disease as a major public health threat is looking like an increasingly achievable goal.

But the situation is much less promising for Australians living with hepatitis B, which is now the most common blood-borne viral infection in Australia. It affects more people than hepatitis C and HIV combined.

Liver cancer death rate rising: study

SBS News, 9/4/19

The rate of liver cancer deaths and diagnoses has increased substantially in the past three decades, yet researchers say little has been done to help Australians most at risk.

While it is considered a relatively rare type of cancer – nearly 2000 people were diagnosed in 2014 – the high mortality rate and increasing incidence of diagnosis has been concerning, researcher Barbara de Graaff says.

Rates were highest in the Northern Territory, mostly due to a higher prevalence of hepatitis B and C.

Cultural and linguistic diversity of people living with chronic hepatitis B

Cultural and linguistic diversity of people living with chronic hepatitis B in 2011–2016: changing migration, shifting epidemiology
Aust NZ J Public Health. 2018; 42:441-3; doi: 10.1111/1753-6405.12826
Abstract
Objective: To estimate the cultural and linguistic diversity in Australians currently living with chronic hepatitis B (CHB), the majority of whom were born overseas, and to identify trends in this diversity over time.
Methods: Estimates were generated by combining Australian census country of birth
information with seroprevalence data generated from antenatal serology linked with
surveillance notifications. The number of people living with CHB was assessed according to country of birth using the 2011 and 2016 censuses.
Results: The total number of Australian residents living with CHB increased by 20% between 2011 and 2016, substantially outpacing population growth. The most common country of birth continued to be China, with the number of Chinese-born Australians living with CHB increasing by 60% in the 5-year period. Decreased numbers were observed for people born in European countries.
Conclusions: The epidemiology of chronic hepatitis B in Australia has shifted over time due to changing migration patterns, with increases in many countries in the Asia-Pacific, African and Middle Eastern regions. 
Implications for public health: Interventions to improve the health of people living with CHB are imperative, and these up-to-date estimates identify priority groups and communities, which are constantly changing.

Disorders of penis development are on the rise and we’re not sure why

By Mark Green and Andrew Pask

In prenatal ultrasounds or at delivery, many new parents look between their baby’s legs: the presence of a penis is taken as a strong sign that it’s a boy.

For humans and other animals, development of a penis was thought to be driven by “male hormones” (androgens) produced entirely by the testes of the male fetus as it grows in the uterus.

However, a new paper released today indicates this might not be the case.

Hepatitis C Virus – for GPs, Nurses and Allied Health Professionals

Sonder, October 2018

In this education session, presenters Dr Dep Huynh, Ms Margery Milner and Mr Jeff Stewart will provide attendees with an update on the risk factors associated with Hepatitis C Virus (HCV) and the management options available.

The presenters will also provide information on liver cirrhosis tests and how to choose and initiate the most appropriate HCV treatment for patients.

Learning objectives

  • Identify and understand the risk factors for HCV screening;
  • Perform correct diagnosis of chronic HCV using reflexive testing;
  • Assess and manage patients for liver cirrhosis using non-invasive tests;
  • Improve patient safety by choosing the most appropriate HCV treatment according to the patient’s characteristics and co-medications;
  • Discuss and improve your understanding on how to initiate HCV treatment.

Presented by

Dr Dep Huynh, Gastroentrologist & Staff Specialist at Queen Elizabeth Hospital,
Clinical Lecturer, University of South Australia

Margery Milner & Jeff Stewart, Nurses at Queen Elizabeth Hospital

Agenda

6.30pm – 7.00pm Registration and dinner
7.00pm – 8.00pm Presentation by Dr Dep Huynh, Gastroentrologist & Staff Specialist at Queen Elizabeth Hospital, Clinical Lecturer, University of South Australia8.00pm – 8.10pm Tea/coffee break
8.10pm – 9.10pm Presentation by Margery Milner & Jeff Stewart, Nurses at Queen Elizabeth Hospital
9.10pm – 9.30pm Questions, evaluation & close

RACGP QI & CPD Category 2, 4 Points

DATE AND TIME

Mon. 5 November 2018

6:15 pm – 9:30 pm ACDT

LOCATION

Arya Restaurant

30/81 O’Connell Street

North Adelaide, SA 5006

This program is funded by the Adelaide Primary Health Network - an Australian Government initiative

 

‘Sussing that doctor out’: Experiences of people affected by hepatitis C regarding private GPs in SA

‘Sussing that doctor out.’ Experiences and perspectives of people affected by hepatitis C regarding engagement with private general practitioners in South Australia: a qualitative study

BMC Fam Pract. 2017 Nov 29;18(1):97. doi: 10.1186/s12875-017-0669-2.

Abstract

Background: Australians with chronic hepatitis C (HCV) can access affordable Direct Acting Antiviral (DAA) treatments with high cure rates (>90%), via General Practitioners (GPs). Benefits from this treatment will be maximised if people with HCV readily disclose and engage with private GPs regarding HCV-related issues. Investigating the perceptions and experiences of people affected by HCV with GPs can allow for this pathway to care for HCV to be improved.

Methods: In 2013–2014, 22 purposively sampled participants from South Australia (SA) were interviewed. They a) had contracted or were at risk of hepatitis C (n = 10), b) were key workers who had clients affected by HCV (n = 6), and c) met both a) and b) criteria (n = 6). The semi-structured interviews were recorded, transcribed and thematically analysed.

Results: People affected by HCV viewed GPs as a source of general healthcare but, due to negative experiences and perceptions, many developed a strategy of “sussing” out doctors before engaging with and disclosing to a GP regarding HCV-related issues. Participants were doubtful about the benefits of engagement and disclosure, and did not assume that they would be provided best-practice care in a non-discriminatory, non-judgemental way. They perceived risks to confidentiality and risks of changes to the care they received from GPs upon disclosure.

Conclusion: GPs may need to act in ways that counteract the perceived risks and persuade people affected by HCV of the benefits of seeking HCV-related care.