Hepatitis B and C
Hepatitis B is a blood-borne and sexually transmissible infection caused by the hepatitis B virus. The virus attacks the liver causing either immediate or long-term (chronic) damage. World-wide, more than 780,000 people die yearly from the consequences of hepatitis B. It is estimated that 77,000 people in NSW have chronic hepatitis B and this number is growing. The Western Sydney local health district has one of the highest rates of hepatitis B infection in NSW due largely to residents migrating from countries where hepatitis B is endemic. A large proportion of people with hepatitis B are unaware of their infection.
Hepatitis B is spread through infected blood and other bodily fluids, usually through a breach in the skin or contact with the internal lining surfaces of the body. In countries with high rates of hepatitis B in the community, hepatitis B is most commonly spread from mother to child at birth or in early childhood.
- Originating from a country where hepatitis B is endemic, including east and south-east Asia; sub-saharan Africa and the southern parts of eastern and central Europe.
- Injecting drugs
- Unprotected sexual contact (heterosexual or homosexual)
- Tattooing with unsterilised equipment
- Needlestick injuries (eg health care workers)
Most people who acquire hepatitis B during childhood (the most common mode of acquisition) go onto develop chronic hepatitis B. People with chronic hepatitis B are at risk of progressive liver inflammation and scarring. In roughly 15% of people, this scarring becomes irreversible and leads to a state called cirrhosis. Patients with cirrhosis can have life-threatening complications such as liver failure and are at higher risk of liver cancer.
Patients who become newly infected as adults have more than a 95% chance of clearing the virus on their own.
People with chronic hepatitis B can be given medications which may slow the progression of cirrhosis and reduce the risk of HCC. Not all patients with chronic hepatitis B require treatment. Discussion with one of our specialists will help determine whether treatment is needed for you.
- Assessment of hepatitis B disease stage and need for treatment
- Treatment of Hepatitis B with oral antivirals such as Entecavir or Tenofovir.
- Treatment of Hepatitis B in late pregnancy to prevent viral transmission
- Access to drug trials for new Hepatitis B treatments
- Liver cancer screening in patients with Hepatitis B
Hepatitis C is a blood borne infection of the liver caused by the hepatitis C virus. Over 70% of people infected will have long-lasting (chronic) inflammation of the liver. Approximately 220,000 people in Australia have hepatitis C.
Hepatitis C virus is transmitted from the blood of an infected person to another. In Australia, the most common way hepatitis C is spread is through injecting drug use and sharing drug-injecting equipment.
You may be at risk of hepatitis C if you have the following risk factors:
- Blood transfusion prior to 1991
- Tattoos and body piercing equipment that have not been properly sterilised
- Born in a country with high rates of hepatitis C- eg Egypt, parts of south-east Asia
- Needlestick injuries
There are many simple treatments available for hepatitis C in 2022 with high success rates for completely eradicating the virus. Direct Acting Antivirals (DAAs) are available to all patients who have active/chronic infection via approved prescribers. Our specialists are approved prescribers and are in contact with a multidisciplinary team of nurses and trial co-ordinators at Westmead and Blacktown Hospitals.
- Assessment of hepatitis C disease stage and need for treatment
- Fibroscan to assess extent of liver scarring (fibrosis)
- Treatment of Hepatitis C with direct acting antivirals (DAAs) Epclusa (Sofosbuvir + Velpatasvir), Harvoni (Sofosbuvir + Ledipasvir) and Vosevi (Sofosbuvir + Velpatasvir + Voxilaprevir).
- Liver cancer screening in patients with Hepatitis C