On the first day of the 2017 Australasian Viral Hepatitis Elimination Conference, Benjamin Cowie from the WHO Collaborating Centre for Viral Hepatitis/Doherty Institute gave an inspiring summary of Australia's Progress in the management of Hepatitis B which challenges us to go further.
Figures from 2015 show 232,600 people in Australia expected to have Hepatitis B, 144,216 diagnosed, 36,534 in care and 14,636 being treated. More than 6,000 notifications for Hepatitis B were made in 2016.
There is a marked variation within Australia of the percentage of people being managed for hepatitis B, with the Southwestern area of Sydney monitoring and treating where appropriate more than 30% of their patients with hepatitis B, but in some areas in Australia areas this figure is as low as <5%.
The challenge then is to work at screening. Asking where a person or their parents were born, or whether they identify as Aboriginal or Torres Strait Islander will help to pick up 2/3 of potential cases. Late diagnosis leads to a marked increase in decompensated cirrhosis and liver cancer.
If we fail to look for Hepatitis B in the appropriate places, we are doing our patients a great disservice, and a potential long term medicolegal disservice to ourselves.