Hepatitis B update: enabling progress towards elimination

Hepatitis B is a common vaccine-preventable and treatable condition. Chronic hepatitis B is often asymptomatic and can be missed if the diagnosis is not actively considered. The World Health Organization and the Australian Government have committed to eliminate hepatitis B as a public health threat by 2030. The tools required to achieve this are available: an effective vaccine, accurate blood tests for diagnosis and monitoring, effective antiviral treatments and access to ultrasound to enable early diagnosis of hepatocellular carcinoma. Risk-based testing approaches are not effective enough to enable Australia to achieve elimination targets; hence, the Fourth National Hepatitis B Strategy 2025-2030 calls for population-wide testing to identify hepatitis B status. Chronic hepatitis B is a lifelong disease that requires long-term monitoring and follow-up irrespective of the stage of disease or whether an individual is taking antiviral treatment. Most healthcare for people living with chronic hepatitis B can be provided in primary care. All medical practitioners and authorised nurse practitioners can now prescribe antiviral therapy for hepatitis B; additional accreditation is no longer required. Holistic care includes the provision of resources in a person's preferred language, peer and cultural support workers, access to a long-term effective model of care, and appropriate monitoring. Continuity of healthcare providers is desirable and an important enabler of sustained engagement in care.