Improving Hepatitis B diagnosis and linkage to care

Who?

The work has been conducted by La Trobe University and the Burnet Institute with the support of non-government agencies including the Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP – www.cevhap.org) with the use of unrestricted educational grants, and other non-government organisations representing people living with viral hepatitis.

Why?

Peer reviewed literature on hepatitis B largely focuses on the clinical or biomedical response to the virus (i.e., testing protocols, advances in therapy, etc.). However, global data shows that a large majority of those infected remain undiagnosed and that only a small minority receives recommended monitoring or life-saving treatment. Against this background, the research sought to understand why so few people with hepatitis B are diagnosed and why even fewer access treatment or other clinical management. The aim of the research was to improve the public health system response to hepatitis B and better address the needs of people with the virus living in the Asia Pacific.

How?

A series of projects using semi-structured qualitative interviews was conducted in Australia, China, Taiwan and Indonesia to obtain the perspective of people with viral hepatitis B and key stakeholders. The projects received ethical approval from the relevant institutions and were each overseen by an advisory committee of academics and people with viral hepatitis with expertise in clinical, epidemiological, social sciences, advocacy and public health expertise, who have acted as co-investigators.

Outcomes

In Australia, this research supported the development of a comprehensive public health approach to hepatitis B, which recognises and responds to the cultural diversity of people and the lived experience of people with hepatitis B. This approach better addresses social marginalisation including stigma and discrimination which people with hepatitis B often experience in their everyday life.

In China, the research has also informed policy responses and identifies hepatitis B as an intergenerational, asymptomatic and often fatal disease with significant social implications such as stigma and discrimination. In other countries, where often most people with hepatitis B are born in China, it is imperative to investigate how these social determinants affect health service provision for hepatitis B.

Funding

Private (unrestricted educational grants from pharmaceutical companies through CEVHAP) and public (Australian government) sources.