College of Healthcare Sciences

Publish Date

6 August 2019

Related Study Areas

Eliminating viral hepatitis by 2030

To promote World Hepatitis Day, JCU Researcher Sarah Larkins is raising awareness about the global health threat of viral hepatitis.

The World Health Organization (WHO) estimates that viral hepatitis causes 1.34 million deaths worldwide per year. As a result, the Australian Government adopted the WHO goal to eliminate hepatitis B and C as a global health threat by 2030.

According to Sarah, unless there is an increase in testing, diagnosis and linkage to care, hepatitis will continue to spread through the Australian population leading to more preventable deaths.

“In Australia, over 400,000 people are living with viral hepatitis and many people can carry the virus without being aware of it,” Sarah says. “Hepatitis is an infectious disease that causes liver inflammation, which increases the risk of developing cirrhosis of the liver, liver cancer or liver failure over time. Hepatitis B and C are spread by direct contact with infected bodily fluids, such as infected blood, unprotected sex or direct spread between a mother and baby.

“Most people infected with viral hepatitis do not show any particular symptoms or will have mild and non-specific symptoms, such as nausea and vomiting, tiredness, tummy pain or yellowish eyes and skin.”

Compared to other countries, Australia has good access to health care and treatment for viral hepatitis. Sarah says primary healthcare services need to provide more support to at-risk Australians.

“Many people at risk of getting hepatitis come from socioeconomically disadvantaged backgrounds with limited health literacy and access to health care,” she says. “Australian primary care systems need to strengthen the way that they reach out and provide non-stigmatising preventative and curative care for disadvantaged and marginalised populations who might be at risk.

“In particular, Aboriginal and Torres Strait Islander peoples, rural and remote residents, people with drug and alcohol problems, sex workers, prisoners and refugee groups, all have higher risk factors for hepatitis yet poorer access to care.”

Aboriginal community on Bathurst Island
Farmer rounding up stock
People who live in rural and remote communities have poorer access to healthcare

More consideration needed for rural and remote health care

According to Sarah, the Australian viral hepatitis treatment and management guidelines need to be updated to consider rural and remote health care challenges.

“Urban-centric clinical practice guidelines are often developed with no understanding of the geographic, resource and workforce challenges inherent in rural and remote workplaces,” she says. “Consideration of infrastructure and support needs around medication supply chains, and blood collection, transport and testing procedures and appropriate staff education are vital.”

The Australian Federal Government has made the cure for hepatitis C available to all people living with the infectious disease in Australia. The current treatment, a tablet taken daily for two to three months, has fewer side effects than earlier treatments.

“Importantly, this is now available to be prescribed by GPs in primary care at no or minimal cost to the patient,” Sarah says.  “This is really important progress to improve the access to treatment to rural, remote and Aboriginal and Torres Strait Islander people living with Hepatitis C.

“Although more than 70,000 Australians with hepatitis C have commenced treatment to cure hepatitis C since 2016, there is still much more to be done to ensure all at-risk people receive testing, treatment and the hepatitis B vaccination.”

Hepatitis B vaccinations are provided free of charge in Australia under the National Immunisation Program. Sarah says there is no cure for hepatitis B.

“Hepatitis B is preventable by vaccination – a very safe and effective vaccine that is now given to all babies. It is extremely important that all those at high risk of contracting hepatitis B are vaccinated.”

To eliminate hepatitis, Sarah recommends increased health care provider education.

“All General Practitioners and primary healthcare providers need to be educated to think of, test for and provide appropriate treatment for hepatitis,” she says. “Adapting the mechanisms used to raise awareness, identify those at risk and provide culturally acceptable, non-judgmental counselling, testing and treatment is really important.”

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Featured researcher

Professor Sarah Larkins

Dean, College of Medicine and Dentistry

Dr Sarah Larkins is Dean of the College of Medicine and Dentistry at JCU. A general practitioner and Professor of Health Systems Strengthening, she is also Director of Research Development for the Division of Tropical Health and Medicine, Co-Director of the Anton Breinl Research Centre for Health Systems Strengthening and Convenor, Clinical Leadership Group, Tropical Australian Academic Health Centre.

Sarah is passionate about collaborating to improve health equity for underserved populations, particularly rural, remote, Indigenous and tropical populations, and training a health workforce with appropriate knowledge, attitudes and skills for this purpose. Working with fantastic teams, Sarah undertakes participatory applied research in Aboriginal and Torres Strait Islander health, health services and workforce, and social accountability in health professional education.