Australian consensus recommendations for the management of hepatitis B

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis B virus (HBV) infection affects nearly 1% of Australians, with higher prevalence in specific groups.
• An estimated 27% of individuals with HBV remain undiagnosed, missing opportunities for timely treatment.
• HBV infection is a significant cause of liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC).

Purpose of the Study:

• To update and highlight key aspects of HBV infection management in Australia.
• To emphasize the importance of early identification and management of HBV in at-risk populations.
• To inform clinicians about recent changes in HBV nomenclature, natural history, and treatment thresholds.

Main Methods:

• Review of current HBV management guidelines and recent scientific updates.
• Focus on diagnostic and treatment strategies for HBV in Australia.
• Emphasis on risk stratification for cirrhosis and HCC development.

Main Results:

• Updated understanding of HBV natural history and diagnostic criteria.
• Defined thresholds for antiviral treatment based on liver tests.
• Identification of patient and viral factors predisposing to cirrhosis and HCC.

Conclusions:

• Timely identification and management of HBV infection are essential to prevent severe liver disease and mother-to-child transmission.
• Antiviral therapy can prevent cirrhosis, HCC, and HBV reactivation.
• Risk stratification and surveillance are key to preventing HBV-related complications, particularly in migrant and Indigenous communities.