Aiming for the elimination of viral hepatitis in Australia, New Zealand, and the Pacific Islands and Territories: Where are we now and barriers to meeting World Health Organization targets by 2030
Corresponding Author
Jess Howell
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Jess Howell and Alisa Pedrana shared first author with equal contribution to the manuscript.Correspondence
Jessica Howell, Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
Email: [email protected]
Search for more papers by this authorAlisa Pedrana
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Jess Howell and Alisa Pedrana shared first author with equal contribution to the manuscript.Search for more papers by this authorBenjamin C Cowie
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
WHO Collaborating Centre for Viral Hepatitis, Doherty Institute, Melbourne, Victoria, Australia
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorJoseph Doyle
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Search for more papers by this authorAneley Getahun
School of Public Health and Primary Care, Fiji National University, Suva, Fiji
Search for more papers by this authorJames Ward
Head Aboriginal Health, Infection and Immunity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
Matthew Flinders Fellow, Flinders University Adelaide, Adelaide, South Australia, Australia
Search for more papers by this authorEd Gane
New Zealand Liver Transplant Unit, Auckland City Hospital, and Department of Medicine, University of Auckland, Auckland, New Zealand
Search for more papers by this authorChris Cunningham
Research Centre for Maõri Health and Development, Massey University, Wellington, New Zealand
Search for more papers by this authorJack Wallace
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
Search for more papers by this authorAlice Lee
Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, University of Sydney, Camperdown, New South Wales, Australia
Hepatitis B Free, Australia
Search for more papers by this authorJioji Malani
School of Public Health and Primary Care, Fiji National University, Suva, Fiji
Search for more papers by this authorAlex Thompson
Department of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Alex Thompson and Margaret E Hellard shared final author with equal supervision of the manuscript.Search for more papers by this authorMargaret E Hellard
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Alex Thompson and Margaret E Hellard shared final author with equal supervision of the manuscript.Search for more papers by this authorCorresponding Author
Jess Howell
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Jess Howell and Alisa Pedrana shared first author with equal contribution to the manuscript.Correspondence
Jessica Howell, Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
Email: [email protected]
Search for more papers by this authorAlisa Pedrana
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Jess Howell and Alisa Pedrana shared first author with equal contribution to the manuscript.Search for more papers by this authorBenjamin C Cowie
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
WHO Collaborating Centre for Viral Hepatitis, Doherty Institute, Melbourne, Victoria, Australia
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorJoseph Doyle
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Search for more papers by this authorAneley Getahun
School of Public Health and Primary Care, Fiji National University, Suva, Fiji
Search for more papers by this authorJames Ward
Head Aboriginal Health, Infection and Immunity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
Matthew Flinders Fellow, Flinders University Adelaide, Adelaide, South Australia, Australia
Search for more papers by this authorEd Gane
New Zealand Liver Transplant Unit, Auckland City Hospital, and Department of Medicine, University of Auckland, Auckland, New Zealand
Search for more papers by this authorChris Cunningham
Research Centre for Maõri Health and Development, Massey University, Wellington, New Zealand
Search for more papers by this authorJack Wallace
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
Search for more papers by this authorAlice Lee
Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, University of Sydney, Camperdown, New South Wales, Australia
Hepatitis B Free, Australia
Search for more papers by this authorJioji Malani
School of Public Health and Primary Care, Fiji National University, Suva, Fiji
Search for more papers by this authorAlex Thompson
Department of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Alex Thompson and Margaret E Hellard shared final author with equal supervision of the manuscript.Search for more papers by this authorMargaret E Hellard
Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia
Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Alex Thompson and Margaret E Hellard shared final author with equal supervision of the manuscript.Search for more papers by this authorAbstract
Viral hepatitis affects more than 320 million people globally, leading to significant morbidity and mortality due to liver failure and hepatocellular carcinoma (HCC). More than 248 million people (3.2% globally) are chronically infected with hepatitis B virus (HBV), and an estimated 80 million people (1.1% globally) are chronically infected with hepatitis C virus (HCV). In 2015, more than 700 000 deaths were directly attributable to HBV, and nearly 500 000 deaths were attributable to HCV infection; 2–5% of HBV-infected people develop HCC per annum irrespective of the presence of cirrhosis, whereas 1–5% HCV-infected people with advanced fibrosis develop HCC per annum. The rapidly escalating global mortality related to HBV and HCV related viral hepatitis to be the 7th leading cause of death worldwide in 2013, from 10th leading cause in 1990. Australia, New Zealand, and Pacific Island Countries and Territories fall within the World Health Organization Western Pacific Region, which has a high prevalence of viral hepatitis and related morbidity, particularly HBV. Remarkably, in this region, HBV-related mortality is greater than for tuberculosis, HIV infection, and malaria combined. The region provides a unique contrast in viral hepatitis prevalence, health system resources, and approaches taken to achieve World Health Organization global elimination targets for HBV and HCV infection. This review highlights the latest evidence in viral hepatitis epidemiology and explores the health resources available to combat viral hepatitis, focusing on the major challenges and critical needs to achieve elimination in Australia, New Zealand, and Pacific Island Countries and Territories.
Supporting Information
| Filename | Description |
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| jgh14457-sup-0001-Supplementary Material.docxWord 2007 document , 66.6 KB |
Table S1 HBsAg prevalence among 5 year old children, DTP3 vaccine coverage, HBV vaccine coverage and birth dose HBV vaccine coverage by country: Australia, New Zealand and the Pacific Islands and Territories. Table S2 Published data on seroprevalence of HBsAg in PICT. Table S3 Seroprevalence of anti-HCV antibody in PICT. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 2015; 386: 1546–1555.
- 2Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1459–1544.
- 3Fattovich G, Bortolotti F, Donato F. Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors. J Hepatol 2008; 48: 335–352.
- 4Esteban JI, Sauleda S, Quer J. The changing epidemiology of hepatitis C virus infection in Europe. J Hepatol 2008; 48: 148–162.
- 5John-Baptiste A, Krahn M, Heathcote J, Laporte A, Tomlinson G. The natural history of hepatitis C infection acquired through injection drug use: meta-analysis and meta-regression. J Hepatol 2010; 53: 245–251.
- 6Stanaway JD, Flaxman AD, Naghavi M et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet 2016; 388: 1081–1088.
- 7 World Health Organisation. Global Hepatitis Report 2017. http://apps.who.int/iris/bitstream/handle/10665/255016/9789241565455-eng.pdf;jsessionid=9DECA1FF83BC4A8C41B74E3BE2649662?sequence=1. 2017.
- 8Gibney KB, Cheng AC, Hall R, Leder K. An overview of the epidemiology of notifiable infectious diseases in Australia, 1991–2011. Epidemiol Infect 2016; 144: 3263–3277.
- 9 Australian Institute of Health and Welfare. The Health and Welfare of Australia's Aboriginal and Torres Strait Islander People. An overview, 2011. Canberra, 2011. 2011.
- 10 NZ Department of Statistics. NZ population and projections. http://www.stats.govt.nz/browse_for_stats/population/estimates_and_projections. 2016.
- 11MacLachlan JH, Allard N, Towell V, Cowie BC. The burden of chronic hepatitis B virus infection in Australia, 2011. Aust N Z J Public Health 2013; 37: 416–422.
- 12MacLachlan J, Allard N, Carville K, Haynes K, Cowie B. Mapping progress in chronic hepatitis B: geographic variation in prevalence, diagnosis, monitoring and treatment, 2013–15. Aust N Z J Public Health 2018; 42: 62–68.
- 13Robinson T, Bullen C, Humphries W, Hornell J, Moyes C. The New Zealand Hepatitis B Screening Programme: screening coverage and prevalence of chronic hepatitis B infection. N Z Med J 2005; 118: U1345.
- 14Reekie J, Gidding HF, Kaldor JM, Liu B. Country of birth and other factors associated with hepatitis B prevalence in a population with high levels of immigration. J Gastroenterol Hepatol 2013; 28: 1539–1544.
- 15Graham S, Guy RJ, Cowie B et al. Chronic hepatitis B prevalence among Aboriginal and Torres Strait Islander Australians since universal vaccination: a systematic review and meta-analysis. BMC Infect Dis 2013; 13: 403.
- 16Nelson PK, Mathers BM, Cowie B et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet 2011; 378: 571–583.
- 17Reekie JM, Levy MH, Richards AH et al. Trends in HIV, hepatitis B and hepatitis C prevalence among Australian prisoners—2004, 2007, 2010. Med J Aust 2014; 200: 277–280.
- 18Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 2014; 61: S45–S57.
- 19Graham S, Harrod ME, Iversen J, Simone Hocking J. Prevalence of hepatitis C among Australian Aboriginal and Torres Strait Islander people: a systematic review and meta-analysis. Hepat Mon 2016; 16: e38640.
- 20Cunningham EHB, Amin J, Bretana N et al. Longitudinal injecting risk behaviours among people with a history of injecting drug use in an Australian prison setting: the HITS-p study. Int J Drug Policy 2017; 54: 18–25.
- 21Lacey C, Ellen S, Devlin H, Wright E, Mijch A. Hepatitis C in psychiatry inpatients: testing rates, prevalence and risk behaviours. Australas Psychiatry 2007; 15: 315–319.
- 22Lagios K, Deane FP. Severe mental illness is a new risk marker for blood-borne viruses and sexually transmitted infections. Aust N Z J Public Health 2007; 31: 562–566.
- 23Poulos R, Ferson M, Orr K et al. Risk factors and seroprevalence of markers for hepatitis A, B and C in persons subject to homelessness in inner Sydney. Aust N Z J Public Health 2007; 31: 247–251.
- 24Jin F, Prestage GP, Matthews G et al. Prevalence, incidence and risk factors for hepatitis C in homosexual men: data from two cohorts of HIV-negative and HIV-positive men in Sydney, Australia. Sex Transm Infect 2010; 86: 25–28.
- 25Saxton PJ, Hughes AJ, Robinson EM. Sexually transmitted diseases and hepatitis in a national sample of men who have sex with men in New Zealand. N Z Med J 2002; 115: U106.
- 26Parker C, Tong SY, Dempsey K et al. Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome. Med J Aust 2014; 201: 470–474.
- 27Messina JP, Humphreys I, Flaxman A et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology 2015; 61: 77–87.
- 28Hallinan R, Byrne A, Amin J, Dore GJ. Hepatitis C virus prevalence and outcomes among injecting drug users on opioid replacement therapy. J Gastroenterol Hepatol 2005; 20: 1082–1086.
- 29Gidding HF, Topp L, Middleton M et al. The epidemiology of hepatitis C in Australia: notifications, treatment uptake and liver transplantations, 1997–2006. J Gastroenterol Hepatol 2009; 24: 1648–1654.
- 30Sievert W, Altraif I, Razavi HA et al. A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver Int 2011; 31: 61–80.
- 31Kemp RMM. Injecting drug users have high rates of hepatitis C, but HIV infection remains uncommon NZ. Public Health Rep 1999; 6: 17–19.
- 32Robinson GM, Reynolds JN, Robinson BJ. Hepatitis C prevalence and needle/syringe sharing behaviours in recent onset injecting drug users. N Z Med J 1995; 108: 103–105.
- 33 The Kirby Institute. Hepatitis B and C in Australia: Annual Surveillance Report Supplement 2016. 2016; https://kirby.unsw.edu.au/sites/default/files/kirby/report/SERP_HepBandC-Annual-Surveillance-Report-Supp-2016.pdf.
- 34Shadur B, MacLachlan J, Cowie B. Hepatitis D virus in Victoria 2000–2009. Intern Med J 2013; 43: 1081–1087.
- 35Ramirez AM, Lee SP, Woodfield DG. Hepatitis delta virus infection: a recently imported disease in New Zealand. N Z Med J 1987; 100: 235–237.
- 36Hong TP, Gow P, Fink M et al. Novel population-based study finding higher than reported hepatocellular carcinoma incidence suggests an updated approach is needed. Hepatology 2016; 63: 1205–1212.
- 37Hajarizadeh B, Grebely J, McManus H et al. Chronic hepatitis C burden and care cascade in Australia in the era of interferon-based treatment. J Gastroenterol Hepatol 2017; 32: 229–236.
- 38Weir RP, Brunton CR, Blakely TA. Chronic liver disease mortality attributable to hepatitis B and C in New Zealand. J Gastroenterol Hepatol 2002; 17: 582–588.
- 39Howell J, Balderson G, Hellard M et al. The increasing burden of potentially preventable liver disease among adult liver transplant recipients: a comparative analysis of liver transplant indication by era in Australia and New Zealand. J Gastroenterol Hepatol 2016; 31: 434–441.
- 40 European Association for the Study of the Liver. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167–185.
- 41MacLachlan JH, Allard NL, Cowie BC. Disparities in hepatitis B vaccine funding in Australian jurisdictions: limiting access for priority populations. Aust N Z J Public Health 2015; 39: 192.
- 42Lucas CR, Milne A, Hopkirk N. Kawerau revisited: hepatitis A and B seroprevalence in 1984 and 1993. N Z Med J 1994; 107: 266–268.
- 43Davies J, Li SQ, Tong SY et al. Establishing contemporary trends in hepatitis B sero-epidemiology in an Indigenous population. PLoS One 2017; 12: e0184082.
- 44Giles ML, Sasadeusz JJ, Garland SM, Grover SR, Hellard ME. An audit of obstetricians' management of women potentially infected with blood-borne viruses. Med J Aust 2004; 180: 328–332.
- 45Iversen J, Wand H, Topp L, Kaldor J, Maher L. Reduction in HCV incidence among injection drug users attending needle and syringe programs in Australia: a linkage study. Am J Public Health 2013; 103: 1436–1444.
- 46Shand FL, Day C, Rawlinson W, Degenhardt L, Martin NG, Nelson EC. Hepatitis C testing and status among opioid substitution treatment clients in New South Wales. Aust N Z J Public Health 2014; 38: 160–164.
- 47Pham ST, Bull RA, Bennett JM et al. Frequent multiple hepatitis C virus infections among injection drug users in a prison setting. Hepatology 2010; 52: 1564–1572.
- 48van Gemert C, Wang J, Simmons J et al. Improving the identification of priority populations to increase hepatitis B testing rates, 2012. BMC Public Health 2016; 16: 95.
- 49Wallace J, Hajarizadeh B, Richmond J, McNally S. Challenges in managing patients in Australia with chronic hepatitis B: the general practitioners' perspective. Aust N Z J Public Health 2013; 37: 405–410.
- 50Blakely T, Salmond C, Tobias M. Hepatitis B virus carrier prevalence in New Zealand: population estimates using the 1987 police and customs personnel survey. N Z Med J 1998; 111: 142–144.
- 51Scott N, Doyle JS, Wilson DP et al. Reaching hepatitis C virus elimination targets requires health system interventions to enhance the care cascade. Int J Drug Policy 2017; 47: 107–116.
- 52Snow K, Scott N, Clothier HJ, MacLachlan JH, Cowie B. Limited provision of diagnostic services to Victorians living with hepatitis C antibodies, 2001–2012: a multi-level modelling analysis. Aust N Z J Public Health 2016.
- 53 The Kirby Institute. Monitoring hepatitis C treatment uptake in Australia. https://kirby.unsw.edu.au/sites/default/files/hiv/attachment/Kirby_HepC_Newsletter_Issue6_2.pdf. 2017.
- 54Hellard M, Doyle JS, Sacks-Davis R, Thompson AJ, McBryde E. Eradication of hepatitis C infection: the importance of targeting people who inject drugs. Hepatology 2014; 59: 366–369.
- 55 WHO: Country cooperation strategy at a glance: Pacific Island countries. http://wpro.who.int/en. 2011.
- 56 WHO Multi-country cooperation strategy for the Pacific 2013–2017. http://www.wpro.who.int/southpacific/who_pacific_mccs.pdf. 2017.
- 57 European Association for the Study of the Liver. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012; 56: 908–943.
- 58Wilson N, Ruff TA, Rana BJ, Leydon J, Locarnini S. The effectiveness of the infant hepatitis B immunisation program in Fiji, Kiribati, Tonga and Vanuatu. Vaccine 2000; 18: 3059–3066.
- 59Getahun A, Baekalia M, Panda N et al. Seroprevalence of hepatitis B surface antigen in pregnant women attending antenatal clinic in Honiara Solomon Islands, 2015. World J Hepatol 2016; 8: 1521–1528.
- 60Moulia-Pelat JP, Spiegel A, Excler JL et al. Control of hepatitis B in French Polynesia with a program of systematic vaccination of newborns with the Genhevac B vaccine. Sante 1996; 6: 11–15.
- 61Harrison GL, Pryor J, Malani J et al. Infection frequency of hepatitis C virus and IL28B haplotypes in Papua New Guinea, Fiji, and Kiribati. PLoS One 2013; 8: e66749.
- 62 World Health Organisation (WHO): Regional action plan for viral hepatitis in the Western Pacific 2016–2020: a priority action plan for awareness, surveillance, prevention and treatment of viral hepatitis in the Western Pacific Region. http://iris.wpro.who.int/handle/10665.1/13141.2016.
- 63Tibbs CJ, Palmer SJ, Coker R et al. Prevalence of hepatitis C in tropical communities: the importance of confirmatory assays. J Med Virol 1991; 34: 143–147.
- 64 HIV surveillance in Pacific Island countries and territories: 2012 report. New Caledonia: Surveillance and Operational Health Research Team, Secretariat of the Pacific Community; 2013. Secretariat of the Pacific Community. 2013.
- 65Han M, Littlejohn M, Yuen L et al. Molecular epidemiology of hepatitis delta virus in the Western Pacific region. J Clin Virol 2014; 61: 34–39.
- 66Vogt TM, Goldstein ST, Kuartei S. Endemic hepatitis B virus infection and chronic liver disease mortality in the Republic of Palau, 1990–2002. Trans R Soc Trop Med Hyg 2006; 100: 1130–1134.
- 67Ott JJ, Horn J, Krause G, Mikolajczyk RT. Time trends of chronic HBV infection over prior decades—a global analysis. J Hepatol 2017; 66: 48–54.
- 68Breakwell L, Anga J, Dadari I, Sadr-Azodi N, Ogaoga D, Patel M. Evaluation of storing hepatitis B vaccine outside the cold chain in the Solomon Islands: identifying opportunities and barriers to implementation. Vaccine 2017; 35: 2770–2774.
- 69Li X, Heffelfinger J, Wiesen E et al. Improving hepatitis B birth dose coverage through village health volunteer training and pregnant women education. Vaccine 2017; 35: 4396–4401.
- 70Howell J, Van Gemert C, Lemoine M, Thursz M, Hellard M. Overview of hepatitis B prevalence, prevention, and management in the Pacific Islands and Territories. J Gastroenterol Hepatol 2014; 29: 1854–1866.
- 71Tuinakelo LR, Tayler-Smith K, Khogali M, Marks GB. Prevalence of anaemia, syphilis and hepatitis B in pregnant women in Nausori, Fiji. Public Health Action 2013; 3: 72–75.
- 72 WHO: Global policy report on the prevention and control of viral hepatitis. http://www.who.int/csr/disease/hepatitis/global_report/en/2012. 2012
- 73Scott N, Palmer A, Morgan C et al. Cost-effectiveness of the controlled temperature chain for the hepatitis B virus birth dose vaccine in various global settings: a modelling study. Lancet Glob Health 2018; 6: e659–e667.
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