OBJECTIVE: To estimate the level of access to diagnosis, management and treatment for people living with chronic hepatitis B (CHB) in Australia, and to identify the gaps in clinical care for people living with CHB. METHODS: Analysis of publicly available population level data including infectious disease notifications, Medicare and Pharmaceutical Benefits Scheme utilisation data, census-based estimates of CHB prevalence and burden, and mathematical modelling. RESULTS: In 2012, of the estimated 218,567 Australians living with CHB, 57% had been diagnosed, 17,367 people (8%) received recommended HBV DNA viral load testing (without treatment) and 10,987 (5%) received antiviral therapy. CONCLUSIONS: This analysis reveals substantial gaps in the cascade of care for CHB in Australia, most notably in diagnosis (with 43% undiagnosed) and in recommended yearly monitoring (87% not in care). The number receiving therapy represents only one-third of those estimated to require treatment to prevent progressive liver disease and liver cancer. IMPLICATIONS: These findings demonstrate that the majority of those affected are not receiving guideline-based care; highlight the need for improvements in opportunistic screening, engagement in care, and access to therapy; and provide a method to assess the impact of public health and clinical interventions in response to CHB over time.
OBJECTIVE: To estimate the level of access to diagnosis, management and treatment for people living with chronic hepatitis B (CHB) in Australia, and to identify the gaps in clinical care for people living with CHB. METHODS: Analysis of publicly available population level data including infectious disease notifications, Medicare and Pharmaceutical Benefits Scheme utilisation data, census-based estimates of CHB prevalence and burden, and mathematical modelling. RESULTS: In 2012, of the estimated 218,567 Australians living with CHB, 57% had been diagnosed, 17,367 people (8%) received recommended HBV DNA viral load testing (without treatment) and 10,987 (5%) received antiviral therapy. CONCLUSIONS: This analysis reveals substantial gaps in the cascade of care for CHB in Australia, most notably in diagnosis (with 43% undiagnosed) and in recommended yearly monitoring (87% not in care). The number receiving therapy represents only one-third of those estimated to require treatment to prevent progressive liver disease and liver cancer. IMPLICATIONS: These findings demonstrate that the majority of those affected are not receiving guideline-based care; highlight the need for improvements in opportunistic screening, engagement in care, and access to therapy; and provide a method to assess the impact of public health and clinical interventions in response to CHB over time.
Authors: Kenneth A Fleming; Susan Horton; Michael L Wilson; Rifat Atun; Kristen DeStigter; John Flanigan; Shahin Sayed; Pierrick Adam; Bertha Aguilar; Savvas Andronikou; Catharina Boehme; William Cherniak; Annie Ny Cheung; Bernice Dahn; Lluis Donoso-Bach; Tania Douglas; Patricia Garcia; Sarwat Hussain; Hari S Iyer; Mikashmi Kohli; Alain B Labrique; Lai-Meng Looi; John G Meara; John Nkengasong; Madhukar Pai; Kara-Lee Pool; Kaushik Ramaiya; Lee Schroeder; Devanshi Shah; Richard Sullivan; Bien-Soo Tan; Kamini Walia Journal: Lancet Date: 2021-10-06 Impact factor: 79.321
Authors: Caroline van Gemert; Julie Wang; Jody Simmons; Benjamin Cowie; Douglas Boyle; Mark Stoove; Chris Enright; Margaret Hellard Journal: BMC Public Health Date: 2016-02-01 Impact factor: 3.295