With more than 300,000 people living with viral hepatitis in Australia1,2, 2024 shapes as a pivotal year as we seek to build momentum towards our goal of elimination of viral hepatitis as a public health threat in 2030.
With more than 300,000 people living with viral hepatitis in Australia1,2, 2024 shapes as a pivotal year as we seek to build momentum towards our goal of elimination of viral hepatitis as a public health threat in 2030.
On 4th July at a World Hepatitis Day parliamentary event, the Australian government re-committed to not only ratifying new strategies to 2030 but also making available $23.7m over two years for Hepatitis B (HBV) and Hepatitis C (HCV) initiatives, as announced in the 2024-25 Federal Budget.
The Fourth National Hepatitis B Strategy 2024-20301 and Sixth National Hepatitis C Strategy 2024-20302, set for imminent public release, identify numerous challenges and opportunities on the path to elimination.
Fundamental to these is the goal to enable ‘equitable access to safe, affordable, and effective prevention, education, testing, management, and treatment, including appropriate person-centred care and support’. They also outline priority populations and milestones to be achieved.
While significant progress has been made on HCV, with almost 80% of people living with HCV diagnosed and 51% treated, the same cannot be said for HBV. More than 200,000 people in Australia are estimated to be living with HBV, with a significant number of these not being engaged in regular care. The graph below shows figures estimated at the end of 2020 and the 2030 elimination targets:
A concerted and focused effort will be required in order to raise awareness of HBV and to encourage people to come forward for testing. But that is only the start - lifelong monitoring is currently required and people must be supported in this. The prospect of a ‘cure’ for HBV within the lifetime of the strategy is an exciting one, and so there is a need to be prepared.
From 1-3 August the 14th Australasian Viral Hepatitis conference3 was held in Darwin. This meeting saw over 300 delegates from all parts of the sector come together to discuss the critical strategies and actions needed to set us on the path to elimination.
Key insights included:
Newly released WHO HBV guidelines4 (Professor Philippa Easterbrook, Imperial College London)
Expanded and simplified criteria for treatment eligibility, which could mean a doubling of the eligible population (50% of HbsAg POS)
Reflex HBV DNA testing be implemented to speed uptake of treatment
HDV testing of all HbsAg POS individuals
‘Testing, testing, testing and case finding’
It is unclear if and how these new guidelines will be implemented in Australia. More evidence and cost effectiveness analysis may be required.
The Hep B PAST study5 performed in the Northern Territory showed that a focused effort tailored to the needs of the community can result in significant increases in diagnosis and linkage to care, with emphasis on delivering services in a holistic and culturally appropriate way. Could this serve as a blueprint for other affected populations?
HCV prevention and diagnosis will require continued focus in order to meet strategy targets including harm reduction, Point of Care RNA testing and laboratory-based HCV RNA reflex testing.
Central to elimination is the role of community, and so we spoke to Dr. Thomas Tu, senior researcher at the Storr Liver Centre at Westmead Hospital (Sydney) and also founder of Hep B community.org and Hepatitis B Voices Australia to understand what Hepatitis elimination means to him.
Hepatitis B Voices Australia is looking for passionate and dedicated volunteers to amplify the voices of people affected by hepatitis. To find out more, head to https://www.hepbvoices.au/volunteer-with-us