As a national strategy to identify and eliminate hepatitis B continues, South Western Sydney is standing out as an example of what can be achieved to reduce infection rates, given the right approach.
The annual Viral Hepatitis Mapping Project: National Report, Hepatitis B 2023 is a collaboration between the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) and the World Health Organisation (WHO) Collaborating Centre for Viral Hepatitis at The Doherty Institute.
It shows substantial gaps across key measures compared to the 2022 targets set out in Australia’s Third National Hepatitis B Strategy 2018-2022.
According to the report, only 24.5 per cent of people living with chronic hepatitis B (CHB) were engaged in care (treatment or monitoring), compared to a target of 50 per cent, and only 12.6 per cent of people living with CHB were receiving treatment, compared to a target of 20 per cent.
What that means is Australia is more than 10 years behind meeting national targets around chronic hepatitis B treatment and care uptake.
But the one exception to that bleak scenario is South Western Sydney.
South Western Sydney PHN (SWSPHN) was the only primary health network to reach the 2022 National Strategy target of 20 per cent, according to the report, with treatment uptake in our region sitting at 20.2 per cent. Projections suggest no other PHNs are due to exceed this target before 2030 if current trajectories continue.
SWSPHN also recorded the highest uptake of care at 37.2 per cent against a target of 50 per cent. In Fairfield it was 45.7 per cent and in Bankstown it was 41.6 per cent.
The proportion of people who received either treatment or monitoring during 2014-2023 varied significantly across the PHNs but the proportion of people who had any history of care engagement in the past 10 years was again highest in South Western Sydney at 72.5 per cent, compared to second place Western Sydney at 71 per cent and third place Northern Sydney at 62.3 per cent.
Hepatitis B is a potentially serious disease which can have long-term effects on those who suffer it, as well as on the community in which they live.
Hepatitis B (HBV) is a virus which causes inflammation of the liver. The infection can be short or long-term. Most healthy adults who get infected with HBV can recover without any long-term problems.
However, some individuals, especially infants, are more likely to develop CHB, a long-term infection which occurs when the body’s immune system cannot eliminate the virus after six months of initial infection.
CHB can persist for the rest of a person’s life and is associated with a higher risk of developing liver damage, cirrhosis and liver cancer. People with CHB can be infectious and can transmit the virus to others.
So, what are the reasons for this impressive result?
SWSPHN Chief Executive Officer, Dr Keith McDonald PhD, said CHB was a major health issue in the South Western Sydney region due to its prevalence – and that made it a high priority for both SWSPHN and local GPs to focus on.
According to the viral mapping report, South Western Sydney has an above average prevalence of CHB and an above average prevalence of liver cancer.
In 2023, there were 14,474 people living with CHB in the region and 2,920 people receiving treatment.
Primary liver cancer numbers are also high in South Western Sydney and may be linked to high rates of hepatitis B and/or C in culturally and linguistically diverse communities.
Dr McDonald said South Western Sydney GPs prioritised the testing and treatment themselves because they were more aware of CHB and its risks.
According to the viral mapping report, 61.5 per cent of CHB monitoring is by a GP in South Western Sydney – above the national average of 54.9 per cent.
“GPs are to be congratulated for their efforts in identifying those affected by hepatitis B and working towards containing its spread throughout the community,” he said.
“I’d also like to acknowledge the hard work of staff at SWSPHN who facilitate and manage a number of projects which promote screening, testing and treatment of CHB.”
SWSPHN provides free hepatitis B prescriber training to GPs and nurse practitioners and has been actively promoting hepatitis B screening and treatment initiation for several years via our CPD, HealthPathways and communication channels.
We also promote the Seek B Hepatitis B Case Finding and Clinical Auditing Pilot Project, an ASHM project which reimburses GPs for their time to develop, recall and test patients.
The project goal is to increase the number of people identified for screening, testing, linkage to care and management for hepatitis B in primary care, thereby reducing the prevalence and mortality rates of hepatitis B in Australia.
A financial reimbursement of $1,000 per module (up to $4,000 total) is provided to participating practices. They can also claim the Practice Incentives Program Quality Improvement (PIP QI) incentive.
SWSPHN also signed a Memorandum of Understanding with ASHM for the Beyond the C program which allows us to also promote and encourage viral hepatitis screening and assessment as part of our work with practices.
In 2024, we provided scholarships for GPs to become S100 prescribers for hepatitis B and the uptake was excellent.
We had 17 scholarships available, and 17 GPs registered, with 12 so far completing all components of the training. They are now recognised as s100 HBV authorised prescribers. The training was organised and facilitated by ASHM specifically for our GPs.
If you’re a community member, find out more about hepatitis B:
Hepatitis B – prevention, symptoms and treatment | healthdirect
Hepatitis B – Health Resource Directory
If you’re a healthcare provider, resources are available at:
