Chronic hepatitis B affects almost one per cent of Australians, many of whom were born in areas outside Australia with high rates of infection, such as Asia, Africa, the Middle East, Central and South America, Eastern Europe, Mediterranean Europe, the South Pacific and the Caribbean. High rates of infection also exist in indigenous populations.
Dr Sally J Bell and Dr Tin Nguyen from the Department of Gastroenterology at St Vincent’s Hospital in Melbourne write about treatments for the disease and the importance of ongoing monitoring of patients with hepatitis B, in the latest edition of Australian Prescriber.
"Most people with hepatitis B in Australia were infected in the womb or during childhood before they migrated. A small number of people acquire infection as adults via injecting drug use or sexual contact," the authors write.
"There are usually no symptoms of hepatitis B infection, and people from countries with high rates of infection, and those at risk of contracting it through needle use or sexual activity should be screened."
"Improved laboratory testing for viral DNA can help identify the need for treatment and long-term risk of liver damage. Therapy, which may last 12 months or longer, reduces inflammation, can improve liver injury and reduces progression to liver cirrhosis and cancer."
"Long-term monitoring is recommended to detect recurring infection and liver cancer, and consists of an abdominal ultrasound and serum alfa-fetoprotein every six months. This is especially important in high-risk patient groups – those with cirrhosis, a family history of liver cancer, Asians older than 35 years (if infected early in life) and Africans older than 20 years," the authors conclude.
(Source: Australian Prescriber: August 2009)