Published Date: 2012-09-10 16:02:48
Subject: PRO/EDR> Hepatitis B & C - Australia: liver cancer increase
Archive Number: 20120910.1288861

HEPATITIS B AND C - AUSTRALIA: LIVER CANCER INCREASE
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Date: Mon 10 Sep 2012
Source: Brisbane Times [edited]
http://www.brisbanetimes.com.au/national/health/hepatitis-epidemic-must-be-tackled-to-stop-liver-cancer-cases-doubling-20120909-25mh8.html


The number of new cases of liver cancer will soar in Australia over the next decade unless urgent action is taken to diagnose and treat an epidemic of viral hepatitis, experts warn. A physician with the Victorian Infectious Diseases Service, Benjamin Cowie, said liver cancer cases were expected to double to about 2500 a year if more was not done to tackle the underlying causes. Hepatitis B and C virus infections were the primary causes of liver cancer, with hepatitis B the most significant single cause of cancer worldwide, after tobacco, Dr Cowie said.

Hepatitis B affected about 200 000 Australians, most of them Aboriginal or born overseas in countries where there was an epidemic. Hepatitis C affected about
230 000 Australians and was most commonly caused by drug users sharing needles. Dr Cowie is among a group of experts to use a viral hepatitis conference in New Zealand today [10 Sep 2012] to urge governments and health professionals to set new targets for the number of people receiving treatment.

"A substantial scaling up of resources and efforts is needed to stop these epidemics in their tracks," the experts said. "Otherwise liver cancer will continue to be among the fastest increasing causes of cancer death in Australia and New Zealand." Targets include ensuring that at least 80 per cent of people with hepatitis B or C are diagnosed and that 5 per cent of people with hepatitis C and 10 per cent of those with hepatitis B receive antiviral treatment every year. It is estimated that one in 3 people with hepatitis B and one in 4 with hepatitis C are undiagnosed. They may not have symptoms of the disease, but without treatment, their condition can progress to liver cancer or liver failure.

Only 2 per cent of Australians who have hepatitis C and 3 per cent with hepatitis B receive medical treatment. Dr Cowie said part of the problem was long waiting lists. "If you are living with hepatitis B and have undiagnosed cirrhosis and wait for a year to be seen, you have a 2 to 3 per cent chance of getting liver cancer. From a human rights perspective, I think that is unacceptable in rich societies like Australia and New Zealand."

Experts said new drugs to treat hepatitis C offered improved efficacy and had less toxicity. "We need to be exploring not just sending people to hospital and waiting for liver clinics but getting these treatments into the community, and that means supporting general practitioners and nurses to take a greater role," Dr Cowie said before today's [10 Sep 2012] 8th Australasian Viral Hepatitis Conference 2012. More than 10 000 Australians and New Zealanders are diagnosed with hepatitis C each year and 7000 with hepatitis B. The "Auckland statement" calls for new hepatitis C infections to be halved by 2016, including by introducing needle and syringe programs in prisons, where the transmission rate for infection is of concern.

[Byline: Kate Hagan]

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[Hepatitis B is a potentially life-threatening liver infection caused by hepatitis B virus. It is a major global health problem and the most serious type of viral hepatitis. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer. Hepatitis B virus is transmitted between people by direct blood-to-blood contact or semen and vaginal fluid of an infected person. Modes of transmission are the same as those for the human immunodeficiency virus (HIV), but the hepatitis B virus is 50 to 100 times more infectious. Unlike HIV, the hepatitis B virus can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. A vaccine against hepatitis B has been available since 1982. Hepatitis B vaccine is 95 percent effective in preventing infection and its chronic consequences and is the 1st vaccine against a major human cancer.

Strangely, immunisation is not mentioned in the above report as one of the measures that might be deployed in the fight against liver cancer.

Hepatitis C is a contagious liver disease that results from infection with hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C virus is usually spread when blood from an infected person enters the body of a susceptible person. It is among the most common viruses that infect the liver. Hepatitis C may be transmitted through sex with an infected person or sharing of personal items contaminated with infectious blood, but these are less common. Hepatitis C is not spread through breast milk, food or water. Diagnosis of acute infection is often missed because a majority of infected people have no symptoms. Specialized tests are needed to evaluate patients for liver disease, including cirrhosis and liver cancer. Hepatitis C does not always require treatment. There are 6 genotypes of hepatitis C, and they respond differently to treatment. However, combination therapy with interferon and several new drugs are proving successful with some types of hepatitis C. There is no vaccine available at present. - Mod.CP

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