Hepatitis B

Hepatitis B cells

Introduction

Hepatitis B is an infectious disease caused by the hepatitis B virus which is transmissible by blood and sexual contact, as well as from mother to child at birth. The virus affects the liver by attaching to healthy liver cells and replicating. If not diagnosed and managed appropriately, hepatitis B infection can lead to cirrhosis (scarring of the liver), liver cancer or liver failure.

During 2015, an estimated 232,600 people were living with chronic hepatitis B. An estimated 62% of these people were diagnosed, these people were in care (monitored or received antiviral therapy), and 14,636 were receiving antiviral therapy. This equates to an estimate of 62% of all people with hepatitis B being diagnosed, 16% of those diagnosed were in care and 6.3% of people diagnosed received antiviral therapy. Australia’s Second National Hepatitis B Strategy 2014–2017 has a target of 80% diagnosis of all people living with chronic hepatitis B and a treatment target of 15% for people living with chronic hepatitis B.

 

You can explore the hepatitis B data from Australia in the interactive graphs below. Click on the tabs above the graph to view hepatitis B notifications by sex, age and state.

Scroll down to read the key findings and to download the full version of the report.

Key Findings

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There were a total of 6,502 notifications of newly diagnosed hepatitis B infection in Australia in 2015, 221 (3%) in Aboriginal and Torres Strait Islander peoples, 2,211 (34%) in the non–Indigenous population, and a further 4,070 (63%) for which Indigenous status was not reported. 

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From 2006–2015, the population rate of notification of hepatitis B infection declined in Australia in younger age groups, but remained high in the 25–29 and 30–39 year age groups.

232,607

 

There were an estimated 232,607 people living with chronic hepatitis B infection in Australia in 2015, of whom 88,621 (38%) were born in the Asia–Pacific, and 21,632 (9.3%) were Aboriginal and Torres Strait Islander peoples.

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In 2015, the estimated chronic hepatitis B prevalence was 4% in people who inject drugs, 3.9% in Aboriginal and Torres Strait Islander peoples, 3.6% in people born in the Asia–Pacific, 3.5% in people born in Sub–Saharan Africa, and 3% in men who have sex with men, with potential overlaps in some of these categories.

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Of 219 people who had a liver transplant in 2015, 17 (8%) had hepatitis B infection.

419

 

An estimated 419 (323–683) deaths attributable to chronic hepatitis B infection occurred in 2015.

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In 2015, an estimated 62% of people with chronic hepatitis B in Australia had been diagnosed. Only 6% of people living with chronic hepatitis B were receiving antiviral therapy in 2015, representing 40% of the 15% estimated to benefit from treatment.

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70% of people attending sexual health clinics in 2015 were immune to hepatitis B, highest in the youngest age group 15–19 years 

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In 2015, coverage of infant hepatitis B vaccination at 24 months of age was 95% in the non–Indigenous population, and 96% in the Aboriginal and Torres Strait Islander population. 

Interpretation

Hepatitis B in adolescents and adults is transmitted through a variety of pathways, including both injecting drug use and sexual transmission. However, most Australians living with chronic hepatitis B acquired the infection at birth or in early childhood.

There is limited information on uptake of testing, so it is not possible to interpret the rate of notification as a proxy for incidence (recent infection), even in young people. However, the trends in newly acquired infections in young people are similar to the trends in the overall diagnosis rates. Age specific analyses in both overall and newly acquired infections indicate a decline in the age groups (<25 years) that are most likely to have benefited from the introduction of universal vaccination of infants in 2000 (1990 in the Northern Territory) and adolescent catch up programs from 1998 (with variation by jurisdiction). Maternal screening and vaccination of infants born to mothers with chronic hepatitis B infection is also likely to have contributed to this decline.

These data presented in the hepatitis B diagnosis and care cascade indicate an ongoing gap in both the uptake of testing to diagnose chronic hepatitis B infection, and the uptake of effective monitoring and treatment to control viral replication.