Trends in chronic viral hepatitis: notifications, treatment uptake and advanced disease burden

摘要

Since the introduction of mandatory notification in the early 1990s, around 110,000 and 260,000 cases of hepatitis B and hepatitis C respectively, have been reported through public health surveillance mechanisms in Australia. The number of hepatitis B notifications is likely to be a considerable underestimation of the number of people living with chronic hepatitis B. Over the period 1998-2008, a small decrease in hepatitis B notifications (around 10%) and a more marked decrease in hepatitis C notifications (around 40%) has occurred, with the latter related to reductions in heroin supply. Rates of antiviral therapy remain low for both chronic hepatitis B (3%) and chronic hepatitis C (2%). Incidence of hepatocellular carcinoma has increased over the period 1990-2002, largely due to increasing contributions of hepatitis B virus and hepatitis C virus related hepatocellular carcinoma. Further increases in hepatocellular carcinoma incidence are projected, particularly if antiviral therapy uptake remains low. A combination of enhanced access to treatment programs and increased hepatocellular carcinoma screening among high risk people with chronic hepatitis B and chronic hepatitis C is required to limit the emerging epidemic of chronic viral hepatitis related hepatocellular carcinoma.