Responding to hepatitis B and hepatitis C

1. Responding to hepatitis B and hepatitis C Lisa Bastian Sexual Health and Blood-borne Virus Program Department of Health Delivering a Healthy WA

2. Blood-borne Viruses in WA

3. Rate of newly acquired hepatitis B and hepatitis C notifications by state and territory in 2010 • Newly acquired hepatitis B: • WA had highest rate in Australia • WA rate 36% higher than for country as a whole • Newly acquired hepatitis C: • WA had second highest rate in Australia • WA rate 80% higher than for country as a whole Source of Data: National Notifiable Diseases Surveillance System, 21-02-11

4. Number of newly acquired hepatitis B and hepatitis C notifications in WA by time period Time period comparison Infection 5 year mean Previous 12 month period Hepatitis B (Newly acq.) 22% decrease 13% decrease Hepatitis C (Newly acq.) 21% decrease 18% increase

5. Rate of newly acquired hepatitis B and hepatitis C notifications by Aboriginality and area in 2010 • Newly acquired hepatitis B: • Two notifications from the metro area • Newly acquired hepatitis C: • Aboriginal people: highest rates in the metro area • non-Aboriginal people: highest rates in the rural area Key: Metro = North Metropolitan + South Metropolitan PHUs Rural = Wheatbelt + Great Southern + Midwest + South West PHUs Remote = Goldfields + Kimberley + Pilbara PHUs

6. Rate of newly acquired hepatitis B and hepatitis C notifications by Aboriginality and age group in 2010 Highest rates Infection Aboriginal people non-Aboriginal people Newly acq. hep. B N/A 25-29 yr olds Newly acq. Hep. C 20-24 yr olds 20-24 yr olds

7. Rate of newly acquired hepatitis B notifications by Aboriginality in WA, 2001 to 2010 • 6% of notifications among Aboriginal people in 2010 • Rate among Aboriginal people has fluctuated • 2010 Aboriginal to non-Aboriginal rate ratio = 1.7:1

8. Rate of newly acquired hepatitis C notifications by Aboriginality in WA, 2001 to 2010 • 13% of notifications among Aboriginal people in 2010 • Rate among Aboriginal people has fluctuated • 2010 Aboriginal to non-Aboriginal rate ratio = 9.7:1

9. Number of BBV tests and notifications in the STI endemic regions by year, WA 2004 to 2009

10. Proportion of BBV tests and notifications in the STI endemic regions by year and sex, WA 2004 to 2009

11. Proportion of BBV tests and notifications in the STI endemic regions by year and age group, WA 2004 to 2009

12. Hepatitis B vaccine coverage • Universal hepatitis B vaccination at birth commenced in Australia in 2000 • Current schedule for hepatitis B vaccine: • Birth, 2 months, 4 months, 6/12 months • Catch-up program for adolescents • For those aged 24-27 months, rates of vaccine coverage are comparable for Aboriginal and non-Aboriginal infants • Decline in prevalence of markers of hepatitis B infection and carriage in Aboriginal and Torres Strait Islander children since the introduction of vaccine

13. Strategic Context

14. National Strategies • Third National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy 2010-2013 • National Hepatitis B Strategy 2010-2013 • Third National Hepatitis C Strategy 2010-2013 • Sixth National HIV Strategy 2010-2013

15. Third National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy 2010-2013 • The goals of the Third National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy 2010-2013 are to: • to reduce the transmission of, and morbidity and mortality caused by, STIs and BBVs • to minimise the personal and social impact of these infections.

16. Linkages: National strategies – WA Plans National Strategies WA Hepatitis C Model of Care WA Hepatitis B and C Implementation Plans Second Western Australian Aboriginal Sexual Health and Blood-borne Virus Strategy

17. WA hepatitis B and C implementation plans – consultation • Draft plans and questionnaire – distributed widely by email • Sent to 180 individuals • Consultation meeting • Currently – sign off on Memorandum of Understanding by key stakeholders

18. Hepatitis C People with hepatitis C People who inject drugs Aboriginal people People in custodial settings People from culturally and linguistically diverse backgrounds People with hepatitis C with co-morbidities Hepatitis B People from culturally and linguistically diverse (CALD) backgrounds (including migrant and refugee populations) Aboriginal people Children born to mothers with chronic hepatitis Unvaccinated adults at higher risk of infection (IDU, MSM etc) Implementation plans – priority populations

19. Implementation plans – priority action areas • The priority issues of the Plan include: • primary prevention for priority populations • secondary prevention and early detection • disease management and tertiary prevention • workforce development • Monitoring and evaluation • WAISHAC • WACBVSS

20. Role of SHBBVP • Implementation of plans at state-wide level in partnership with key stakeholders • Funding • Health promotion and prevention activities • Education and workforce development • Support state-wide campaigns (Hepatitis WA) • Vaccination program • Coordination of state-wide needle and syringe program

21. Resources • Vaccines • Health promotion resources and hardware • Assistance with establishing/maintaining needle and syringe programs • Workforce development grant and bursaries http://www.public.health.wa.gov.au/ • Hepatitis B and C on-line education program http://hepatitis.ecu.edu.au/ • DAO - Blood-borne Virus Capacity Building Project Ursula Swan: 9471 0445 or ursula.swan@health.wa.gov.au

22. Contacts Jude Bevan, Senior Policy Officer, SHBBVP Judith.Bevan@health.wa.gov.au 9388 4827 Hepatitis WA http://hepatitiswa.com.au/info@hepatitiswa.com.au 9227 9800