Hepatitis B and Hepatitis C notification

Published

22 Nov, 2017

Chronic hepatitis B or C infection is the most common risk factor for liver cancer.¹ Together these diseases are estimated to cause up to 80% of liver cancer cases globally.² Studies have shown that the risk of developing liver cancer can be up to 20 times higher in people with chronic hepatitis infection than among the general population.^3,4

It has been projected that in 2016, there will be 1,840 new diagnoses and 1,805 deaths due to liver cancer in Australia. In addition, the age-standardised mortality rate for liver cancer has been increasing over time, from 2 deaths per 100,000 persons in 1980 to 6 per 100,000 in 2013 (see NCCI Indicator – Mortality).

Summary

Notification rates for Hepatitis B and C differed by sexIn 2015 the Hepatitis B notification rates for males were 29 per 100,000 personsn compared to 26 for females. For Hepatitis C, notifications for males (61 per 100,000 persons) were nearly double that for females (31 per 100,000 persons).

Notification rates for Hepatitis B and C have decreased over timeFrom 2006 to 2015  notification rates for Hepatitis B and hepatitis C have both decreased (Hepatitis B from 31 to 28 per 100,000 persons and Hepatitis C from 60 to 46 per 100,000 persons), although rates have remained largely unchanged since 2011.

Data

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Hepatitis B or C

Notes

• Data sourced from the Kirby Institute - HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016.
• Total includes data where sex is unknown.

New diagnoses of Hepatitis B and Hepatitis C, 2006 - 2015
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Data sourced from the Kirby Institute - HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016.

Hepatitis B and Hepatitis C notification rate per 100,000 population, 2006-2015
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Data sourced from the Kirby Institute - HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016.

Hepatitis B and Hepatitis C notification rate per 100,000 population, by remoteness
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Hepatitis B or C

Notes

• Data sourced from the Kirby Institute - HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016.
• Includes Hepatitis B and C data from NT, SA, Tasmania and WA, and ACT for Hepatitis B only.

Hepatitis B and Hepatitis C notification rate per 100,000 population, by Indigenous status

About this measure

In Australia, the prevalence of both chronic hepatitis B and hepatitis C is approximately 1% of the population,^5,6 with a higher prevalence occurring in people born in certain countries (such as Vietnam, Cambodia, China, Taiwan and Afghanistan) and Aboriginal and Torres Strait Islander peoples.^5,7 This measure focuses on people newly diagnosed with hepatitis B or hepatitis C (including people with newly acquired and unspecified duration of infection) as notified through the Australian National Notifiable Diseases Surveillance System.

There are multiple risk factors for acquiring hepatitis B, including injecting drug use and unprotected sex, although people living with chronic hepatitis B in Australia acquired infection at birth or in early childhood.^6,8 Childhood immunisation with the hepatitis B vaccine therefore plays an important role in reducing the risk of acquiring the disease (see NCCI Indicator – Hepatitis B vaccination). It is estimated that only 62% of people with chronic hepatitis B in Australia have been diagnosed with the disease.⁶

The primary risk factor for hepatitis C is the re-use of needles and syringes, meaning that hepatitis C tends to be concentrated among people who inject drugs, prisoners, and people from high prevalence countries.^6,9

Current status

In 2015 the unadjusted notification rate for hepatitis B was 28 cases per 100,000 population. Rates were slightly higher among males (29 cases per 100,000 population) than among females (26 cases per 100,000 population).

The notification rate for hepatitis C (including people with newly acquired and unspecified duration of infection) in 2015 was higher, at 46 cases per 100,000. The difference in rates were also larger, with the notification rate among males being 61 cases per 100,000 population compared to 31 cases per 100,000 population among females. Notification rates for both hepatitis B and hepatitis C are highest in young adults (aged 20 to 39 years).⁶

Aboriginal and Torres Strait Islander peoples

Data for hepatitis B and hepatitis C notifications by Indigenous status are available from a limited number of jurisdictions, and therefore should be treated with caution (refer to About the Data). Nonetheless, where data was available hepatitis B notification rates were 3 times greater among Aboriginal and Torres Strait Islander peoples when compared to the non-Indigenous people, and hepatitis C notification rates 4.6 times greater.⁶

Remoteness

In 2015, the notification rate for hepatitis B was highest in Major Cities (33 per 100,000 population), while the notification rate for hepatitis C was highest in both Inner Regional and Outer Regional areas of Australia (60 per 100,000 population).

Trends

The notification rates for hepatitis B and hepatitis C have both decreased over time, although rates have remained similar since 2011. Notification rates for both diseases were higher in 2006 (31 and 60 cases per 100,000 population respectively) than in 2015 (28 and 46 cases per 100,000 population). Where data is available, there has been an increase in the hepatitis C notification rate in Aboriginal and Torres Strait Islander peoples between 2011 and 2015. This may reflect greater exposure to injecting risk behaviours and relatively high rates of incarceration among Aboriginal and Torres Strait Islander peoples.^6,9,10

About the data

This measure shows the number and rate (per 100,000 population) of people newly diagnosed with hepatitis B or hepatitis C in Australia, which includes both newly acquired and unspecified cases.

Numerator: People newly diagnosed with hepatitis B or hepatitis C in Australia (both newly acquired and unspecified), as recorded in the National Notifiable Diseases Surveillance System.

Denominator: Estimated residential population (Australia).

Data sources

Australian data are from the National Notifiable Diseases Surveillance System (NNDS). The NNDS collates disease notifications made to the relevant state or territory health authority under the provisions of the public health legislation in each jurisdiction. Hepatitis B and hepatitis C are notifiable diseases in all states and territories. More information on the NNDS is available at http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-nndss-nndssintro.htm.

Extensive analyses of NNDS data relevant to this measure are provided in annual surveillance reports produced by the Kirby Institute for infection and immunity in society.⁶ The HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016 is the primary source of data used for this measure.

Comparable international data are not available for this measure.

Data caveat

Data related to notifiable diseases are generally of a very high quality in Australia. However, data related to Indigenous status is only available from the following jurisdictions, and caution is therefore advised in the interpretation of these data as they may not be nationally representative:

Hepatitis B: Australian Capital Territory, Northern Territory, South Australia, Tasmania and Western Australia.
Hepatitis C: Northern Territory, South Australia, Tasmania and Western Australia.

References

Activity in this area

Data:

Australian Government Department of Health. National Notifiable Disease Surveillance System. Available here: www9.health.gov.au/cda/source/cda-index.cfm

The Kirby Institute for infection and immunity in society: Surveillance: http://kirby.unsw.edu.au/surveillance

Policy:

Australian Government Department of Health. Fifth National Hepatitis C Strategy
2018-2022. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-1//$File/Hep-C-Fifth-Nat-Strategy-2018-22.pdf

Australian Government Department of Health. Third National Hepatitis B Strategy
2018-2022. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-1//$File/Hep-B-Third-Nat-Strategy-2018-22.pdf

References

1. American Cancer Society 2014. Liver Cancer. Available from: https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/risk-factors.html (accessed 9 August 2017).

2. Cancer Council Victoria. Hepatitis B & liver cancer. Available from: www.cancervic.org.au/for-health-professionals/community-health-professionals/hepatitis-b-and-liver-cancer (accessed 5 January 2016).

3. Amin J et al. 2006. Cancer incidence in people with hepatitis B or C infection: a large community-based linkage study. J Hepatol45(2):197-203.

4. Cancer Council Australia. National Cancer Control Policy – Liver Cancer. Available at: http://wiki.cancer.org.au/policy/Liver_cancer (accessed October 2016).

5. Antonsson A et. al. 2015. Cancers in Australia in 2010 attributable to infectious agents. Aust NZ J Public Health. 2015; 39:446-51.

6. The Kirby Institute 2016. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016. The Kirby Institute, UNSW: Sydney, Australia

7. The Kirby Institute 2015. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2015. The Kirby Institute, UNSW: Sydney, Australia

8. Australian Government Department of Health 2014. Second National Hepatitis B Strategy 2014-2017. Department of Health: Canberra.

9. Australian Government Department of Health 2014. Fourth National Hepatitis C Strategy 2014-2017. Department of Health: Canberra.

10. Australia Bureau of Statistics 2015. Prisoners in Australia. Cat. No. 4517.0. ABS: Canberra.

Revision Type

Minor

Version Number

1.1

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Summary

Notification rates for Hepatitis B and C differed by sex

Notification rates for Hepatitis B and C have decreased over time

Data