Internal Medicine Journal
Volume 42, Issue 8, 2012, Pages 880-886

Hepatitis B status in migrants and refugees: Increasing health burden in Western Australia (Article)

Subramaniam K.* , Flexman J. , Tarquinio L. , Thambiran A. , Hopkins S. , Cheng W.
  • a Departments of Gastroenterology and Hepatology, Royal Perth Hospital, Australia
  • b Departments of Microbiology and Infectious Diseases, Royal Perth Hospital, Australia, Department of Microbiology and Infectious Diseases, Pathwest Laboratory Medicine, Australia
  • c Departments of Gastroenterology and Hepatology, Royal Perth Hospital, Australia
  • d Migrant Health Unit, North Metropolitan Area Health Service, Australia, School of Paediatrics and Child Health, University of WA, Australia
  • e Centre for International Health, Curtin University, Perth, WA, Australia
  • f Departments of Gastroenterology and Hepatology, Royal Perth Hospital, Australia, Centre for International Health, Curtin University, Perth, WA, Australia

Abstract

Background: In light of increasing migration from endemic countries with chronic hepatitis B (CHB), this study describes the changing epidemiology of CHB patients born outside Australia referred to a tertiary hospital in Western Australia. It aims to stratify risk and progression to cirrhosis and hepatocellular carcinoma according to viral factors and to provide an indication of the growing burden of disease and current and future treatment costs. Methods: Demographic, serological and biochemical data were obtained from patients with CHB between July 2002 and December 2008. Hepatitis B virus DNA quantification was performed to assess baseline viral loads in the patients. Total cost estimates for surveillance and treatment are based on probabilities of the population anticipated to be at a given stage of the disease in a given year. Results: There is a progressive increase in referrals (n=478) with the majority coming from Asia (57%) and Africa (35%). The mean age of Africans is 11years less than that of Asians, with a lower proportion of Africans having hepatitis B virus DNA>2000IU/mL compared with Asians (36.7% vs 54.3%). Approximately 50% of CHB patients referred are at risk of cirrhosis and hepatocellular carcinoma unless treated. Without treatment, a substantial increase in cost over 10years (from $401460 to $2027078) is estimated at 400%. Conclusion: This study highlights the increasing burden of CHB in Western Australia, from people born in endemic countries, in particular, the direct costs of treatment. It will help to develop strategies that can be tailored to Western Australia with appropriate allocation of resources. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

Author Keywords

Viral factor Western Australia migrant Chronic hepatitis B Refugee

Index Keywords

immigrant refugee virus DNA liver cirrhosis human risk assessment Refugees middle aged Asia priority journal Aged Young Adult health care cost Humans virus detection Adolescent male female Aged, 80 and over patient referral Africa cost of illness Western Australia liver cell carcinoma Article major clinical study adult Hepatitis B, Chronic virus load age distribution public health problem Transients and Migrants quantitative analysis hepatitis B
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84865359327&doi=10.1111%2fj.1445-5994.2011.02711.x&partnerID=40&md5=90f22ae1f497912f443e69ba373a6137
DOI: 10.1111/j.1445-5994.2011.02711.x
ISSN: 14440903
Original Language: English