Chronic hepatitis B predicted to soar

The number of people in Australia with chronic hepatitis B infection (HBV) is predicted to increase markedly over the next decade, according to a new report released by the Australian Centre for Economic Research on Health (ACERH) at the Australian National University (ANU).

The Impact of Chronic Hepatitis B in Australia: Projecting Mortality, Morbidity and Economic Impact, co-authored by Professor Jim Butler and Dr Rosemary Korda at ANU, and two clinicians, suggests that a national strategy involving a coordinated approach to screening, vaccination, and treatment of the disease is warranted.

"There appears to be a lack of appreciation of the potential benefits of identifying and treating those infected," said Dr Korda. "Although Australia has adopted universal hepatitis B vaccination for infants, there are many people already infected for whom vaccination offers no benefit.

"Immigration patterns, the ageing of the infected pool of individuals and the small number of people receiving HBV drug therapy, together imply that the long-term pathology of HBV infection can be expected to become increasingly evident over the next decade."

According to the report, under current levels of medical management and treatment:

• The number of people living with chronic hepatitis B infection will increase from 187,000 to 276,000;
• The number of deaths attributable to chronic hepatitis B each year will increase from 450 in 2008 to 1,550 in 2017;
• There will be a three-fold increase in the number of people living with liver cancer directly caused by hepatitis B.

The researchers say that increases in the rate of infection could be mitigated through the development of a national strategy for Hepatitis B, which would increase awareness of the disease and encourage those infected to seek treatment.

"Our cost-effectiveness analyses indicate investment in such a strategy is economically justified given the looming increase in the numbers of people infected and the drug therapies that are available to treat those infected," said Professor Butler.

(Source: Australian National University: The Impact of Chronic Hepatitis B in Australia: Projecting Mortality, Morbidity and Economic Impact: October 2009)