NSW HEPATITIS INFOLINE

Media Release: NSW’s Mandatory Disease Testing Bill ill-conceived and flawed

Media Release: NSW’s Mandatory Disease Testing Bill ill-conceived and flawed

Media Release: NSW’s Mandatory Disease Testing Bill ill-conceived and flawedSpeaking at a NSW Legislative Committee Inquiry into the Mandatory Disease Testing Bill 2020, on Thursday 11 February, Hepatitis NSW restated our concerns related to this ill-conceived and flawed legislation.

Hepatitis NSW CEO Steven Drew said, “Hepatitis NSW absolutely supports frontline health and emergency services workers. We collaborate with many of them every day through our work. They should not be subjected to unnecessary threats or risk as they go about their job and it is abhorrent that attacks do occur that create health related stress and concern.”

“Frontline workers must be informed and educated in advance, and reassured by experts that, based on science and evidence, the likelihood of the transmission of a blood-borne virus as the result of spitting or skin contact with blood is non-existent,” said Mr Drew. On this basis, the inclusion of saliva within the definition of ‘body fluids’ which can be used to seek a mandatory testing order in the Bill is redundant and raises questions as to the real purpose of this legislation.

“We are part of a concerted effort by the community, government, and health sectors to eliminate both hepatitis B and hepatitis C in New South Wales by 2028,” said Mr Drew. “Efforts to date have resulted in the hard won ongoing decline in prevalence of hepatitis B and hepatitis C. Both viruses now present a numerically small and ever diminishing health risk in NSW.”

“There is an effective cure for hepatitis C and a vaccination for hepatitis B. This means the fear and worry, which this legislation validates, is unwarranted and not justifiable. Instead, rather than entrench stigma and discrimination, we need scientific, evidence-based information and education to reduce stress and anxiety for frontline workers who are at risk of incidents of exposure. This reflects New South Wales world leading approach and response to public health issues.”

This Bill will make it harder to reach the very people we must still reach to make good on elimination.

Since 2000, a comprehensive hepatitis B vaccination program in NSW means an entire generation of young people are not at, and pose no risk of, infection. Additionally, frontline workers should already be vaccinated against hepatitis B to mitigate occupational health and safety risks of blood borne virus transmission.

Furthermore, an effective cure for hepatitis C is universally available through the PBS, including for young people aged 12 and above. That this Bill applies to young people aged 14 years and above is as unjustifiable as it is abhorrent.

“The importance of protecting and promoting the health, well-being, and mental health of staff, employees, workers and indeed the public is something we all agree on. Workplaces have an obligation to do everything possible to protect staff from injury and harm while carrying out their duties. Although the rationale for this Bill is to protect and promote the health and well-being of frontline workers we already, in fact, have the tools to do so.”

The current system already places the health and safety of the worker at the centre of risk assessment and prevention. It prioritises evidence-based assessment, treatment, and care. In the event of an incident, focus should always be placed on access to immediate assessment of risk by a qualified health practitioner, counselling, and support to the person. This support would see the commencement of any recommended aftercare, including post-exposure prophylaxis.

Mr Drew said, “Requiring an alleged assailant to undertake a blood test, potentially without consent and under duress, does not provide peace of mind. It would be an unnecessary and fallible substitute for the immediate clinical assessment of the affected worker by an expert and appropriate care protocols.”

It is important to state clearly and unambiguously that enacting this Bill will disproportionately and adversely impact an already disadvantaged population, notably street present and marginalised people – specifically Aboriginal and Torres Strait Islander people, as well as people who have substance dependence, gender identity, and mental health issues.

“The Bill will effectively offer no increased peace of mind to frontline workers,” said Mr Drew, “but would instead expose predominantly marginalised individuals to unnecessary and invasive blood testing, potentially inflaming violent behaviour and increasing the risk of injury to both the alleged assailant and the frontline worker.”

  • Download our submission>>> CLICK HERE
  • Read other submissions – NSW Parliament site>>> CLICK HERE

For more information, please contact:

Hepatitis NSW
Steven Drew, CEO
sdrew@hep.org.au
0402 518 285

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What you need to know about hep B | part 4

What you need to know about hep B | part 4

This article – part 4 of 8 – was written by Dr Alice Lee , Gastroenterologist and Hepatologist, Concord Repatriation General Hospital.

Liver cancer | part 1

One of the most serious complications of hepatitis B is the development of liver cancer. All people with chronic hepatitis B infection are potentially at risk of developing liver cancer. Even so, some are at higher risks than others. There are screening protocols for those at high risk, regardless everyone with hepatitis B should be considered for screening.

The primary cause of liver cancer is hepatitis B, not alcohol

High risk hepatitis B groups for increased risk of liver cancer are anyone with cirrhosis, a family history of liver cancer, and older people (men over 40 years and women over 50 years). However, people outside of this group can still develop liver cancers and they require close monitoring. As discussed previously, all people with hepatitis B require lifelong monitoring for both the liver condition and for consideration of liver cancer screening.

There are different types of cancers that can affect the liver. Primary liver cancers are cancers that develop in the liver cells – known as “hepatocytes”. Other types of liver cells such as bile duct cells can also lead to cancer, but this is not directly related to hepatitis B. Cancers from other sites can also spread to the liver so that liver cancers can be secondary to cancers that have started elsewhere. This article will discuss the primary type, which is refered to as liver cancer or hepatocellular cancer.

Liver cancer is one of the most common cancers in the world

Primary liver cancer is one of the most common cancers in the world – ranking fifth – and is the second leading cause of cancer related deaths in the world. It is one of the cancers that is continuing to increase in number. Apart from hepatitis B, there are other conditions that can increase the chance of developing liver cancer. This includes cirrhosis from any cause. This could include alcohol, fatty liver, hepatitis C, autoimmune liver disease, iron storage disease as well as metabolic conditions. Cirrhosis is a condition of severe liver scarring that covers a wide spectrum of symptoms, and so some patients may not realise that they have cirrhosis until they are very sick. It can sometimes be picked up early by blood tests as well as some imaging studies. Anyone with ongoing abnormal liver tests should ask their doctor about how their liver is doing.

It’s not easy to find liver cancer – multiple tests are needed

Screening for liver cancer is recommended in groups of patients at increased risk. This is done using a liver ultrasound and, in some cases, a tumour marker blood test – an alpha fetoprotein (AFP) – every six months. Since liver inflammation, cirrhosis and non-related liver diseases such as pregnancy and testicular cancer can cause an elevated AFP, there is ongoing research to try and find an accurate and simple blood test to identify liver cancer early.

Liver ultrasound is simple and safe as there is no radiation exposure. Preparation for the procedure requires fasting. As with all tests, there are limitations. It relies on the skills of the sonographer, the patient’s body build/physique and fasting state. Patients are asked to fast because the bowel can get in the way and overlying gas can limit the views of the liver. In very large patients with fatty liver, the fat in the liver can make visualization difficult so that small liver lesions may not be found. Other liver conditions such as liver cirrhosis and the presence of many cysts can also interfere with getting good visualisation.

Liver cancer is more dangerous without symptoms

In a liver ultrasound, doctors are looking to find new, very small liver spots – often less than 1 cm across. Screening with an ultrasound is usually just a lead-in to other tests that will clarify the nature of any new liver spot. Not all new lesions are cancer, but all new liver lesions in people with underlying risk factor for liver cancer need further close scrutiny.

Next: In Part 5, to be published next week, Dr Lee will write more about liver cancer.

Published 4 February, 2021

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Hepatitis NSW Submission: Mandatory Disease Testing Bill 2020

Mandatory Disease Testing a futile and stigmatising exerciseHepatitis NSW has provided a submission on the Mandatory Disease Testing Bill 2020 currently being considered by the State Government, and will shortly be attending a committee hearing at NSW Parliament House. Hepatitis NSW has opposed mandatory disease testing since it was first considered following recommendations arising in the 2017 NSW Legislative Assembly Committee on Law and Safety Report. Our position remains unchanged.

Download our submission>>> CLICK HERE

The proposed bill won’t address risk to frontline workers

We strongly believe that the wellbeing and safety of frontline workers in NSW is vitally important. In terms of wellbeing and safety, we are referring not just to the physical but also to mental and emotional wellbeing. Our frontline workers deserve the community’s respect and should not be subject to acts of intimidation, threats or violence in any form. They must be protected as much as is reasonably possible in a high-level occupational risk environment.

In providing that protection, it is essential that the strategies designed and used are scientifically informed, evidence-based and effective in meeting the aim; that they are fit for purpose. Where the issue being addressed is a health issue, the response must be health based, not based on criminalising affected people.

A health informed and based response provides a holistic, wraparound approach that draws on appropriate health promotion, medical support, interventions and care to the primarily affected person. Force and criminalisation against a third party is punitive and does not provide sanctuary for a victim.

This Bill is a blunt instrument that is wholly incapable of achieving anything other than a perpetuation of fear, loathing, discrimination and privileging that is inconsistent with the inclusive, fair and responsible society and behaviour we would all desire. It will not address the stress and concerns of frontline workers around the exceedingly low risk of infection. Indeed, greater results will be achieved through supporting them with accurate information about risks, addressing their concerns, and providing professional wellbeing, support and counselling.

We do not support mandatory testing

Mandatory testing is not in line with the Australian National HIV, Hepatitis B or Hepatitis C Testing Policies, or supported by global health bodies. The key principles guiding blood borne virus (BBV) testing in Australia are that testing is conducted ethically, is voluntary and performed with the informed consent of the person being tested.

Mandatory testing does not meet these principles. Mandatory testing laws are not supported by global health bodies such as UNAIDS and the World Health Organization on the basis that it breaches human rights, compromises public health initiatives and other efforts to eliminate HIV and other BBV transmission.

  • Download our submission>>> CLICK HERE
  • Read other submissions – NSW Parliament site>>> CLICK HERE

For more information, please contact:

Hepatitis NSW
Steven Drew, CEO
sdrew@hep.org.au
0402 518 285

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What you need to know about hep B | part 3

What you need to know about hep B | part 3

This article – part 3 of 8 – was written by Dr Alice Lee , Gastroenterologist and Hepatologist, Concord Repatriation General Hospital.

Hepatitis B treatment under other circumstances

There are special groups of patients for whom treatment is needed outside of the standard setting. This includes patients who need to undergo significant immune suppressive therapy; women who are pregnant and at risk of transmitting the virus to their unborn baby; and patients with co-infections such as HIV, hepatitis C or other significant chronic health conditions that place them at increased risk of complications. Family history of complications of liver disease such as liver cirrhosis and cancer are also considered as risk factors.

Our immune system causes liver scarring

The hepatitis B virus itself does not cause direct damage to the liver. Such damage is due to our immune systems response to the virus which causes the liver to become inflamed. Over time, this inflammation can lead to scarring. However, in certain clinical situations, when a person’s immune system is altered by medical treatment, hepatitis B can become “reactivated”. For instance, someone who is having cancer chemotherapy will have medicines to suppress their immune system. When the treatment is finished, their immune system becomes active again and this activity can lead to a flare of hepatitis. This is referred to as immune reactivation. Reactivation can be mild, and seen on routine bloods; but, in rare cases, this can be so severe that it can lead to liver failure. Having prophylaxis with antiviral therapy for hepatitis B can save the patient’s life.

There are non-cancer medicines that are also used to suppress the immune system for a variety of immune related disorders. These can also cause immune reactivation. Hepatitis B treatment is therefore given whilst on immunosuppressive therapy, and after stopping, for about six months. The doctor will test for hepatitis B and will advise what may be needed.

Hep B test for all pregnant women

Pregnant women are the other group of hepatitis B affected people where hep B treatment may be considered as a preventative measure. All pregnant women are screened for hepatitis B. In some cases, it may be the first time they find out they are hepatitis B positive. It is important that you receive lots of counselling about this condition and be assessed to determine whether you should have treatment or not. If you do not need treatment, a special blood test to measure the amount of virus in your blood will be done during pregnancy. This is to see whether there is an increased risk of transmitting the virus to the baby at birth.

Hep B vaccine for all newborn babies

In Australia, all babies (irrespective of their mother’s hepatitis B status) are given a hepatitis B vaccine at birth. For babies born to hep B positive mothers, an additional injection of an immune globulin is also given. Despite this, there is still a risk of the baby acquiring hepatitis B if there is a lot of the virus in the mother’s blood at birth. Hence, viral load during her pregnancy helps to determine whether additional medicines can be given to reduce this further. Tenofovir is the usual drug offered and is given around week 28 of pregnancy and stopped at some time after delivery. An obstetrician will work closely with the liver specialist in making sure the mother and her unborn baby are protected.

In addition to having treatment with regular monitoring, a mum to be needs to ensure that she takes good care of her health. General wellbeing including regular exercise, a well-balanced diet with high fibre, plenty of vegetables and protein is important. Avoiding excessive weight gain will also ensure other health benefits.

Next: In Part 4, to be published next week, Dr Lee will write about liver cancer.

Published 28 January, 2021

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What you need to know about hep B | part 2

What you need to know about hep B | part 2

This article – part 2 of 8 – was written by Dr. Alice Lee , Gastroenterologist and Hepatologist, Concord Repatriation General Hospital.

Diagnosing And Treating Hepatitis B

Once a diagnosis of chronic hepatitis B is confirmed through blood tests, an assessment is made. The assessment will be based on health history (including family history of liver cancer), a physical examination, further blood tests, ultrasound or CT and special imaging called Fibroscan. These are needed to determine whether treatment for hepatitis B is required, or if someone only needs to be monitored for now.

A careful assessment is needed to ensure that someone will benefit from hepatitis B treatment. There are two main reasons for this. Firstly, a person can have a chronic infection without it progressing to complications such as cirrhosis or liver cancer. Secondly, hepatitis B treatment (unlike hep C treatment) is not curative and is, in most cases, long term or lifelong once commenced.

What Is Cirrhosis And Can It Be Treated?

When the liver cells are damaged they become inflamed or swollen – this is called liver fibrosis. Over time this can build up and lead to cirrhosis of the liver – which is actual scar tissue in the liver. The scar tissue reduces blood flow through the liver. The liver then can’t do its work as well as it should.

All patients with cirrhosis should have treatment. Diagnosis of cirrhosis can be simple, but in some cases may require a combination of blood test, scans and a fibroscan that measure liver scarring. A fibroscan is a special type of non-invasive scan, like an ultrasound.

In people without cirrhosis, high liver function (ALT) readings associated with high virus count are indications for hepatitis B treatment. Even where an ALT reads normal, indicating no need for treatment, it can still go up without the person being aware. Hence, the need for regular check-ups – usually every six to twelve months.

Other considerations for treatment are older age, and a family history of liver cancer.

How To Treat Hepatitis?

Treatment for hepatitis B, if required, is very simple. It is one pill per day. There are one of two medicines that are used – entecavir or tenofovir. The medication is best taken at the same time each day (entecavir away from food; tenofovir is not affected by eating). Neither drug is associated with significant side effects but, as with all medicines, side effects are possible.

Tenofovir has been associated with renal issues and a doctor will need to regularly monitor kidney function. Both medicines need to be reduced to a lower dose if the person has reduced kidney function and this needs to be discussed with the doctor.

Once treatment is underway, it is really important that the medicines are taken regularly as resistance can occur, and there is also a risk of worsening liver disease, such as a flare, after stopping the medicine. These tablets are generally prescribed by specialists, but some GPs can also prescribe these medicines.

Regular monitoring whilst on treatment, usually six-monthly, is also critical with blood tests and ultrasound. The medicine is taken to control the amount of hepatitis B virus in the blood, which then leads to decrease in liver damage.

These hep B treatments have been available for decades and have been shown to be lifesaving, preventing and, potentially, reversing liver damage.

Can Hepatitis B Be Cured?

There are currently no cures for hepatitis B.

Liver cancer risks are lowered with treatment, but there is still a need for ongoing screening as the risks are not completely averted. The goals of treatment are initially to improve the liver tests (to get an ALT normalisation) and to stop the virus from replicating . In the long term, some patients have what is referred to as a “functional cure”, where the hep B surface antigen becomes negative.

For the small percentage of people who achieve this, usually after many years of treatment, their treatment can sometimes be stopped. Even after stopping treatment, they will still require ongoing monitoring. Regardless, where cirrhosis is present, lifelong treatment is still recommended.

For those who do not have cirrhosis, it remains critical that they discuss any interruption or cessation of medicines with their doctors.

What Is The New Medicine For Hepatitis B?

Treatments that have been available in the past include medicines such as lamivudine and interferon. There are limited roles for these medicines for special circumstances. New drugs are constantly under development in order to improve outcomes.

A newer version of tenofovir is available (tenofovir alafenamide) which is associated with fewer kidney issues. It is currently not widely available and not government funded.

Other drugs are being studied as ongoing efforts are being made to find a cure for hepatitis B.

Next: In Part 3, to be published next week, Dr. Lee looks at  other issues and circumstances around treatment.

Published 19 January, 2021

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What you need to know about hep B | part 1

What you need to know about hep B - part 1

This article – part 1 of 8 – was written by Dr. Alice Lee , Gastroenterologist and Hepatologist, Concord Repatriation General Hospital.

Referred to as the ‘silent killer, hepatitis B lives up to its name. Despite great efforts around the world to increase awareness of this virus, and to improve prevention, testing and treatment, there has sadly been no decline in global mortality rates. Nearly one million people die from hepatitis B, and its complications, every year.

What makes hepatitis B such a difficult and lethal virus?

Hepatitis B is a highly infectious virus, more so than hepatitis C and even HIV. In some parts of the world, the prevalence rates are very high – up to 20%. For Korean people, the prevalence rates have been markedly reduced by nationwide vaccination programs, but those who already have the infection remain at risk.

Even with vaccination, there are instances where, for those at high risk – such as babies born to mothers who have hepatitis B – vaccination may not be enough to prevent infection. Also, in some cases, one course of hepatitis B vaccine might not be adequate and further vaccination courses may be needed. It is safest for people to have a doctor check their blood tests – looking for protective antibody levels – to ensure that they are not in this group.

How do we test for hepatitis B?

Testing for hepatitis B is done by blood tests, but the levels of bloods tests can change over time whether you have treatment or not. Blood tests detect whether a person has:

  • the virus (hepatitis B surface antigen),
  • had the virus (hepatitis B core antibody) and/or
  • protection against infection (hepatitis B surface antibody).

Anyone living with the virus (hepatitis B surface antigen),will need to have further tests to see if they need to have treatment. The results of the tests can change over time, which can lead to misunderstanding about a person’s status.

Further testing is done through more blood tests and scans. It can be very complex and confusing to patients, but they should continue to check in with their doctors as it can save their life. Even if someone does not need treatment now, they may need to have treatment at a later date. Most people who need treatment are asymptomatic and may feel that they are alright and do not need to have checkups. This can be very dangerous because, if someone leaves it until they feel sick, then it may be too late.

How is hepatitis B monitored?

Hepatitis B can cause liver cirrhosis and liver cancer. While most people will live a normal healthy life with hepatitis B and not have any complications, identifying who is at risk, and who is not, is not so easy. Some key risks includes those who have a family history of liver cancer, other conditions that can increase risk of hepatitis B complications – such as other viruses or those who drink excessively – older patients, patients who have severe scarring of the liver(cirrhosis), have high liver enzymes (ALT) and those with high levels of virus (Hepatitis B DNA). All these factors are taken into consideration over time to decide whether treatment is required, or not, at a particular time.

Liver cancer is the most common cause of death from hepatitis B. It is also asymptomatic until very advanced and the best way to check for it is with regular ultrasounds and blood tests. If there are concerns about spots on your liver, a doctor may advise to have additional tests such as CT or MRI scans. All patients with a family history of liver cancer and all with cirrhosis should have checkups at least every six months.

Whether a person with hepatitis B is receiving treatment or not, screening can save their life. Ultrasounds are safe, there is no radiation, and they do not hurt. Anyone can have an ultrasound, as many times as needed. CT scans require radiation and hence should only be done when advised from a doctor. MRI is also available and accessible through a doctor. The benefits of an MRI is that there is no radiation, but it requires contrast (that is, requires the injection of a dye) and so is indicated for some patients only. People should ask their doctor about this if they have any concerns.

Next: In Part 2, to be published next week, Dr. Lee looks at  treatment options for Hepatitis B.

Published 12 January, 2021

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Professor Bob Batey wins 2020 Hepatitis NSW Cheryl Burman Award

Professor Bob Batey wins 2020 Hepatitis NSW Cheryl Burman AwardHepatitis NSW is delighted to announce that Professor Robert (Bob) Batey is the 2020 winner of our Annual Cheryl Burman Award, which acknowledges outstanding work or achievements by an individual or team in NSW within the viral hepatitis sector.

Hepatitis NSW CEO Steven Drew said, “The Cheryl Burman Award this year recognises Professor Batey’s distinguished career of service to communities affected by viral hepatitis through research, clinical excellence, prioritising patient needs and advocacy.”

Professor Batey trained at Sydney Hospital, Royal Prince Alfred Hospital, and the Royal Free Hospital in London. This training was the start of a fifty years plus career which has included internal medicine, gastroenterology, hepatology, and substance dependency medicine. He has held numerous prominent positions within the hepatology sector, providing clinical guidance and expertise in frontline clinical roles as well as policy development and leadership positions at a state and national level.

Mr Drew said, “As an advocate for the affected hepatitis C community, Professor Batey was a member of the group of clinicians who lobbied the Federal Government to ensure equitable access to treatment.” The first subsidised treatment for hepatitis C – Interferon – was listed on the Pharmaceutical Benefits Scheme (PBS) in 1994 and was placed under the management of Professor Batey and the National Interferon Database.

“Collaborating with Hepatitis NSW in 1995, he devoted many hours and much energy to provide education to the public, dispelling myths and reducing stigma and discrimination experienced by the affected community,” said Mr Drew.

He was the first Visiting Medical Officer to provide hepatitis C treatment and care services in NSW custodial settings, treating his first patient in 1996.

Professor Batey visited many regional and rural locations within NSW to assist in the education of staff, leading to the development and commencement in hepatitis C treatment and care services in places such as Coffs Harbour, Tamworth, Port Macquarie, and Lismore. He has also supported the southern part of the state, providing Visiting Medical Officer clinics to Wagga Wagga, Albury, and Nowra.

In 2002, Professor Batey was awarded the Member of the Order of Australia (AM), for services to Medicine in the field of hepatitis C, medical education, and research.

Mr Drew said, “Professor Bob Batey has always put the needs of the patient and the affected community as the priority, to ensure their needs are not only heard but addressed.”

“The outstanding work being done by individuals across NSW to improve health outcomes for people living with and affected by hepatitis B and hepatitis C is inspiring,” said Mr Drew. “This is demonstrated by the calibre of the of our other finalists, Sinead Sheils and Bill Lenane.”

Sinead Sheils was nominated for her substantial contribution to improving the quality of life of people living with viral hepatitis. Her clinical approach has ensured great outcomes for all stakeholders, including clients. As a Hepatology Nurse Practitioner at the Royal Prince Alfred Hospital, Ms Sheils has built workforce capacity and initiated evidence-based best practice.

Bill Lenane was nominated for his long standing and ongoing commitment, and efforts in community advocacy and representation. As an Illawarra based volunteer with lived experience of hepatitis C, Mr Lenane has worked to increase the profile and voice of people in that region with lived experience of hepatitis C.

Mr Drew said, “Hepatitis NSW congratulates Bob, as well as finalists Sinead and Bill, and thanks all nominees for this year’s award. Once again, all nominees for this year’s award demonstrated strong leadership and initiative in the sector.”

Published 26 November, 2020

For a list of previous Chery Burman Award Recipients>>>CLICK HERE

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The worst thing about hep B isn’t always the virus

The Worst Thing About Hep B Isn’t Always The Virus

Mary, one of our Hepatitis Speakers, has written a guest blog post about her experience of living with hepatitis B.

I have lived with hep B for all of my life. Although this is a virus that can badly damage the liver, the worst thing about it has mostly been the lack of information about it and the behaviour of other people towards me when they find out I have hep B.

No one told me what I should do about having hep B

Until after a check-up for my pregnancy, I hadn’t known that I had hep B. Even then, no one told me what I should do about it, and so neither the doctor nor myself paid it much attention. I certainly didn’t know that my son should get a vaccination for hep B within 12 hours of his birth, so it was very lucky that he was not also infected.

The discrimination against my hep B status began to impact my friendships

After migrating, in 2000, to Sydney from China, a very good friend of mine offered tremendous support to help me with my settlement. Australia was such a new environment and her help was very much appreciated. But, one day, without warning, she just walked away from me when she saw me… and never spoke to me again. She instantly became like a stranger to me.

Then I realised it was because she must have known about my hep B status. She and I went to the same doctor, and I believe she found out through there. This hurt a lot, and I was very sad about the loss of our long-term friendship. After this, I never told other friends that I had hep B and, even carried my own cutlery (even though the virus cannot be passed on through a shared eating utensil!).

The health effects of hep B became too much for me

Later, I had a breakout of hep B, and my liver function tests showed that the virus might be damaging my liver. The doctor prescribed anti-viral medication, which helped to get my blood indicators back to normal. The doctor said I needed to take this treatment every day for the rest of my life, otherwise the virus would most likely become resistant to the medicine.

While I have followed the doctor’s advice, concerns over my health and the social pressures of living with hep B have had a dramatic effect on my personality. I became withdrawn and began to lose too much weight.

Joining Hepatitis NSW activities turned my life around!

Luckily, all this has now changed. I got to know Hepatitis NSW, joined in their activities with the Sydney Chinese community and even became a Hep B speaker! Having now acquired more knowledge about hepatitis, I am confident that people living with hep B can lead a long and healthy life. More so, I know that while those who have hep B should encourage people close to them to get tested, they also have the right to keep their personal health matters private.

I have shared my experience with a great number of people from different communities and a variety of backgrounds. This, along with being an active participant in dancing activities, has greatly improved my mental wellbeing. I’ve even regained that lost weight!

Published 10 September, 2020

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Media Release | Reducing the burden of hepatitis on World Hepatitis Day

Reducing the burden of hepatitis on World Hepatitis DayTens of thousands of people in NSW are living with viral hepatitis. Of greatest concern are hep B and hep C – two viruses that can become life-long chronic conditions, eventually leading to liver cirrhosis, liver cancer and sadly, all too often, death. A significant percentage of people living with hep B or hep C are unaware they have it. Even where people know their status, many thousands experience barriers to accessing healthcare, treatment, or cure.

What is the significance of World Hepatitis Day?

World Hepatitis Day is an important event to highlight these issues and drive better outcomes. NSW Hepatitis Awareness Week starts on Monday 27 July, with World Hepatitis Day on Tuesday 28 July. A key activity for this year is the roll out of the bright, eye-catching artwork – wall posters, street pole posters, pull up banners, and pubs and clubs washroom advertising – throughout New South Wales. The messaging focuses on the availability and effectiveness of new hep C treatments.

For hep B, while there is currently no cure, babies born in Australia are vaccinated against it; also, any adult who needs to be vaccinated can be. Hep B testing is available and encouraged for anyone from an at-risk group. Should a person be found to be living with hep B they can have regular monitoring of their liver health, and, if required, treatment to manage their viral load.

For hep C, all Australians over the age of 12 have access to effective and affordable direct acting antiviral (DAA) cures. Hep C treatment is available through local doctors. Community organisations and government agencies work to raise awareness of the cure and help people into and through treatment.

70,000 Australians have been cured of hepatitis C since 2016

Being cured of hep C can improve quality of life. Many people who have finished their course of treatment report feeling greater levels of energy and alertness.

Since the DAAs became available in Australia in 2016, more than 70,000 Australians have been cured of hepatitis C.

Hepatitis NSW CEO, Mr Steven Drew said the medications have a cure rate of 95 per cent. “They can be prescribed by any general practitioner, as well as authorised nurse practitioners. Cure is usually achieved within 8 or 12 weeks, with minimal or no side-effects.”

“These oral pill treatments have offered a revolutionary opportunity,” said Mr Drew. “It is important that people see their health professional to be treated and get their best life back. While hepatitis C initially has almost no symptoms, if left untreated it can ultimately result in significant liver disease.”

We have the rare opportunity to eliminate a chronic disease

Mr Drew said testing for hepatitis C was simple and easy as getting your GP to do a blood test.

“We’ve all led varied and adventurous lives filled with new experiences. It may be that some, or one, of those experiences exposed us to the chance of hepatitis C transmission. The only way to know for sure is to see your GP to have a blood test for hep C.”

“Should you learn you do have hep C, please seriously consider commencing treatment and get cured,” said Mr Drew.

“It is not often we get the chance to eliminate a chronic disease, but we have that opportunity now with hepatitis C,” said Mr Drew. “I encourage anyone who hasn’t yet sought out this medication to explore their treatment options,” adding that Hepatitis NSW could provide information and support to anyone living with, or affected by hepatitis including family and friends of people living with hepatitis C.

“I encourage people to contact the Hepatitis NSW Infoline on 1800 803 990 for more information about the treatment options available or hepatitis generally. You can also contact us using our online chat function on our website hep.org.au.”

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10 Facts about viral hepatitis for World Hepatitis Day!

10 Facts about viral hepatitis for World Hepatitis Day!

This article was written by Dr Alice Lee , Gastroenterologist and Hepatologist, Concord Repatriation General Hospital.

July 28 is World Hepatitis Day, marking a day where community organisations, clinicians, researchers, and governments raise awareness to the global burden of viral hepatitis. This year’s theme is “finding the missing millions” – in recognition of the many people around the world unaware they are living with hepatitis B and/or hepatitis C.

Did you know the date of World Hepatitis Day is also the birthday of Nobel prize winner Dr Baruch Blumberg? He not only discovered the hepatitis B virus, but also developed a diagnostic test and vaccine for the virus.

Here are ten more facts about hepatitis…

1. There are 5 viruses that predominantly affect the liver…hepatitis A, B, C, D, and E

They are all different viruses and are transmitted through different pathways. Hepatitis A and E are mostly spread through faecal-oral route and are preventable by hand hygiene and careful food preparation. Hepatitis A is more common in Korean communities and is also vaccine preventable. Hepatitis B is spread through blood and body fluids, hepatitis C through blood to blood contact. Hepatitis D only occurs in people infected with hepatitis B and is uncommon in Korean patients.

2. There are over 300 million people in the world that live with viral hepatitis

Less than 20% of the people with the virus are aware that they have the infection. The prevalence rates of hepatitis vary throughout the world, some areas have high rates of hepatitis B of over 10%. Higher rates of hepatitis B are seen in older Koreans born before vaccination programs were available.

3. More than 1.5 million people die each year from viral hepatitis

Many people are unaware of their diagnosis until the very late stages of disease and are often too late to be saved. Causes of death include acute liver failure, but the most common cause of death is liver cancer. Described as a ‘silent killer’, those unaware of their status may only have symptoms when the disease is very advanced and when options of treatment are very limited. It’s important to know your status!

4. Prevention of hepatitis remains central in eliminating viral hepatitis

Vaccines are available for both hepatitis B and for hepatitis A. Hepatitis B vaccine is now a part of Australia’s childhood vaccination schedule, starting at birth. It is safe for people of any age to have, even when pregnant. All people should be vaccinated. Know your status and get vaccinated if you are not protected. Those who are family members or partners of positive patients can access free vaccines through NSW health. Ask your doctor.

5. Hepatitis B and hepatitis C are transmitted through blood

Avoid sharing IV needles/syringes, razor blades and toothbrushes. It is safe to share meals, hug your family and friends. Stigma and discrimination is not acceptable. Talk to your health care provider if you have any concerns.

6. Hepatitis B, C, and D can lead to chronic liver disease, cirrhosis, and liver cancer

Many people can continue to have a healthy and normal life without realising their liver is being damaged. It is essential that, if you are at risk, you see your doctor regularly and get checkups. Taking care of yourself is also very important, in addition to getting vaccinated, avoid excess alcohol and do not smoke, take care not to take medications that can cause liver injury. Focus on a healthy diet, exercise and stay lean.

7. Hepatitis B can be treated

Treatment, for those who require it, is available in the form of an oral tablet. If you are living with hepatitis B, your doctor will assess whether you need treatment based on blood tests, your history and other test results. Even if you do not need treatment, you may need treatment later. Lifelong checkups are needed.

8. Hepatitis C can be cured

People with hepatitis C virus – confirmed with a PCR test – are eligible for treatment in Australia. Tablets are taken for 8 or 12 weeks and the treatment cures more than 95% of cases. Ask your doctor about this!!

9. Beware immune suppression

If you have a medical condition that requires immune suppression, you may be at risk of hepatitis B reactivation (meaning an increase in virus activity in the liver). Know your status and ask your doctor.

10. People with viral hepatitis can be at increased risk of liver cancer

Screening can lead to early detection and curative treatment. Liver cancer is the most common cause of death in patients with hepatitis B. It is asymptomatic and the only way to diagnose it early is by screening. If you have hepatitis B, you may need screening. This is simple, using an ultrasound on a six-monthly basis. It could save your life. High risk groups include older people, those with advanced disease (liver cirrhosis) and a family history of liver cancer. Treatment is available.

Celebrate World Hepatitis Day by spreading awareness about viral hepatitis

You or someone close to you, loved ones can be impacted by hepatitis. Celebrate World Hepatitis Day as a hepatitis community to increase awareness, talk about hepatitis and address the ongoing challenges of increasing prevention, diagnosis and treatment.

You, or someone you know could be one of the “missing millions” … you can play a part in “finding” them. You could save a life – yours, or someone you love.

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