Chronic hepatitis B prevalence in Australian Aboriginal and Torres Strait Islander people before and after implementing a universal vaccination program: a systematic review and meta-analysis

Graham, Simon; MacLachlan, Jennifer H; Gunaratnam, Praveena; Cowie, Benjamin C

doi:10.1071/sh18150

Cited by 10 publications

(17 citation statements)

References 51 publications

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“…Limitations to the model arise where there is unavailability of, or uncertainty in, source data. This particularly applied to prevalence estimates by age for priority populations, including Aboriginal and Torres Strait Islander peoples . Work to establish more rigorous estimates, and to apply these together with specific natural history and treatment coverage data to a dedicated model simulating CHB in Aboriginal and Torres Strait Islander Australians, is ongoing.…”

Section: Discussionmentioning

confidence: 99%

“…Baseline prevalence in the model incorporates the population of Australia in 1951, preceding the onset of substantial migration from intermediate and high CHB populations. Whereas baseline prevalence includes both Aboriginal and Torres Strait Islander Australians (who have a significantly higher prevalence of CHB) and non‐Indigenous Australians, specific modeling of CHB in Indigenous Australians was not included. The number of people living with CHB migrating to Australia each year was derived using the estimated prevalence of CHB according to COB.…”

Section: Methodsmentioning

confidence: 99%

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Modeling Progress Toward Elimination of Hepatitis B in Australia

et al. 2019

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Background and Aims Chronic hepatitis B (CHB) is a significant global health concern, and the most prevalent blood‐borne virus in Australia. World Health Organization (WHO) member states have committed to global elimination, with targets to diagnose 90% of people living with CHB, treat 80% of those eligible, and reduce attributable deaths by 65% by the year 2030. Australia has committed to national targets of 80% diagnosed, 20% on treatment, and a 30% reduction in deaths by 2022. Approach and Results We constructed and implemented a mathematical model to estimate the burden of CHB incorporating vaccination, phases of infection, cirrhosis progression, and mortality attributed to decompensated cirrhosis and hepatocellular carcinoma and examined the population‐level impact of antiviral therapy. Diversity was integrated according to migration patterns, CHB prevalence by country of birth, Indigenous status, and age. Modelled outcomes were subjected to multivariate uncertainty analysis. Of the estimated 221,420 people living with CHB in Australia in 2017, 68% were diagnosed and 8.7% were receiving treatment (less than one‐third of those estimated to be eligible). Based on current trends, the proportion of people living with CHB who have been diagnosed will reach 71% by 2022 and 81% by 2030, and treatment uptake will rise to 11.2% by 2022 and 12.9% by 2030, resulting in a 5.7% reduction in CHB‐attributable deaths from 2015 to 2030. CHB treatment has prevented approximately 2,300 deaths in Australia between 2000 and 2017. Conclusions Australia is not on track to meet local and global targets regarding CHB. Comprehensive and regularly updated modelling approaches accounting for diversity within the population are a useful tool to measure progress and impact of interventions, and quantify further improvements required to meet elimination goals.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Modeling Progress Toward Elimination of Hepatitis B in Australia

et al. 2019

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“…Alcohol misuse and smoking are common among Australians, including Aboriginal peoples, and contribute to liver fibrosis progression and carcinogenesis 13 . Prevalence rates of viral hepatitis are higher among Aboriginal peoples than the rest of the Australian population 14,15 . Hepatitis B virus (HBV) infection is reported at four times the rate among Aboriginal peoples (4%) compared with the rest of the Australian population (1%) and is the primary aetiology in 40.5% of HCC patients 14 .…”

Section: Introductionmentioning

confidence: 99%

“…Prevalence rates of viral hepatitis are higher among Aboriginal peoples than the rest of the Australian population 14,15 . Hepatitis B virus (HBV) infection is reported at four times the rate among Aboriginal peoples (4%) compared with the rest of the Australian population (1%) and is the primary aetiology in 40.5% of HCC patients 14 . Moreover, Aboriginal peoples have a more aggressive HBV genotype (C4) associated with rapid progression of liver disease and HCC risk 16 .…”

Section: Introductionmentioning

confidence: 99%

Current issues in the prevalence, diagnosis and management of hepatocellular carcinoma in Australia

Lubel

Roberts

Howell

et al. 2021

Internal Medicine Journal

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Hepatocellular carcinoma (HCC) is the commonest primary liver cancer encountered in the community and a leading cause of cancer morbidity and mortality. In Australia, there are several current important issues that need to be addressed in HCC management. There is a dramatically rising incidence of HCC in Australia with comparatively poorer outcomes in remote regions and in socioeconomic disadvantaged groups. Aboriginal people have a greater incidence of HCC on a background of increased liver disease prevalence and face several barriers to delivery of better healthcare outcomes compared to other Australians. The previously adopted use of imaging alone to diagnose HCC is now being challenged with biopsy likely to become increasingly necessary with the increased uptake of personalised medicine management. Managing HCC is complex involving many disciplines with the multidisciplinary team approach being the current accepted standard of care for patients. New immunotherapy combinations promise to offer patients with advanced HCC promising novel management options. However, the Australian inequities in prevalence, diagnosis and service provision, especially in Aboriginal people, need to be redressed concurrently with the adoption of new HCC management options.

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“…CHB disproportionately affects Indigenous populations globally [2] and this is similar in Australia. A recent systematic review and meta-analysis showed an overall prevalence of 10.8% in pre and 3.5% in post-universal vaccination populations in Aboriginal and Torres Strait Islander people (hereafter respectfully referred to as Aboriginal) in Australia [3]. CHB is endemic in Aboriginal people of the Northern Territory (NT) of Australia, with a contemporary estimated prevalence of 6.1% [4].…”

Section: Introductionmentioning

confidence: 99%

Data linkage and computerised algorithmic coding to enhance individual clinical care for Aboriginal people living with chronic hepatitis B in the Northern Territory of Australia – Is it feasible?

et al. 2020

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BackgroundChronic hepatitis B (CHB) is endemic in the Aboriginal population of Australia's Northern Territory (NT). However, many people's hepatitis B virus (HBV) status remains unknown. Objective 1. To maximise the utility of existing HBV test and vaccination data in the NT by creating a linked dataset and computerised algorithmic coding. 2. To undertake rigorous quality assurance processes to establish feasibility of using the linked dataset and computerised algorithmic coding for individual care for people living with CHB. MethodsStep 1: We used deterministic data linkage to merge information from three separate patient databases. HBV testing and vaccination data from 2008-2016 was linked and extracted for 19,314 people from 21 remote Aboriginal communities in the Top End of the NT. Step 2: A computerised algorithm was developed to allocate one of ten HBV codes to each individual.Step 3: A quality assurance process was undertaken by a clinician, using standardised processes, manually reviewing all three databases, for a subset of 5,293 Aboriginal people from five communities to check the accuracy of each allocated code.

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Chronic hepatitis B prevalence in Australian Aboriginal and Torres Strait Islander people before and after implementing a universal vaccination program: a systematic review and meta-analysis

Cited by 10 publications

References 51 publications

Modeling Progress Toward Elimination of Hepatitis B in Australia

Modeling Progress Toward Elimination of Hepatitis B in Australia

Current issues in the prevalence, diagnosis and management of hepatocellular carcinoma in Australia

Data linkage and computerised algorithmic coding to enhance individual clinical care for Aboriginal people living with chronic hepatitis B in the Northern Territory of Australia – Is it feasible?

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