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Time to decompensated cirrhosis and hepatocellular carcinoma after an HBV or HCV notification: A population-based

Maryam Alavi1, Matthew G Law1, Jason Grebely1

  • 1The Kirby Institute, UNSW Australia, Sydney, NSW, Australia.

Journal of Hepatology
|July 13, 2016
PubMed

Insights

Late diagnosis of hepatitis B (HBV) and hepatitis C (HCV) significantly decreased in Australia since the early 2000s. Continued efforts in hepatitis screening are crucial, especially for HBV, to further reduce risks of advanced liver disease.

Area of Science:

  • Hepatology
  • Public Health
  • Epidemiology

Background:

  • Delayed diagnosis of hepatitis B virus (HBV) and hepatitis C virus (HCV) increases the risk of severe liver disease complications.
  • Advanced liver disease includes decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC).

Purpose of the Study:

  • To characterize the phenomenon of "late hepatitis notification" among individuals diagnosed with HBV or HCV and advanced liver disease in New South Wales, Australia.
  • To assess trends in late hepatitis notification over time.

Main Methods:

  • Linked HBV/HCV notification data (1995-2012) with cancer registry and hospital admission records.
  • Defined "late hepatitis notification" as diagnosis occurring at or after, or within two years prior to, a diagnosis of DC or HCC.

Main Results:

  • Large cohorts of HBV (n=50,958) and HCV (n=79,727) were analyzed.
  • Significant declines in late notification were observed for both HBV and HCV among patients with DC and HCC between 2001-2002 and 2011-2012.
  • For decompensated cirrhosis, late HBV notification dropped from 64% to 31%, and late HCV notification from 52% to 22%.
  • For hepatocellular carcinoma, late HBV notification decreased from 68% to 29%, and late HCV notification from 51% to 17%.

Conclusions:

  • Despite significant reductions, late hepatitis notification remains a concern, particularly for HBV.
  • Further enhancements in hepatitis screening programs are necessary.
  • The study suggests "late hepatitis notification" can serve as a valuable metric for evaluating population-level HBV/HCV screening effectiveness.
Abstract

Keywords:
Decompensated cirrhosisHepatocellular carcinomaLate HBV notificationLate HCV notificationPopulation-level screening

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