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J Gastroenterol Hepatol. 2019 Jan;34(1):40-48. doi: 10.1111/jgh.14457. Epub 2018 Sep 27.

Aiming for the elimination of viral hepatitis in Australia, New Zealand, and the Pacific Islands and Territories: Where are we now and barriers to meeting World Health Organization targets by 2030.

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Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia.
School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Department of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
WHO Collaborating Centre for Viral Hepatitis, Doherty Institute, Melbourne, Victoria, Australia.
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia.
School of Public Health and Primary Care, Fiji National University, Suva, Fiji.
Head Aboriginal Health, Infection and Immunity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Matthew Flinders Fellow, Flinders University Adelaide, Adelaide, South Australia, Australia.
New Zealand Liver Transplant Unit, Auckland City Hospital, and Department of Medicine, University of Auckland, Auckland, New Zealand.
Research Centre for Maõri Health and Development, Massey University, Wellington, New Zealand.
Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia.
Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, University of Sydney, Camperdown, New South Wales, Australia.
Hepatitis B Free, Australia.


Viral hepatitis affects more than 320 million people globally, leading to significant morbidity and mortality due to liver failure and hepatocellular carcinoma (HCC). More than 248 million people (3.2% globally) are chronically infected with hepatitis B virus (HBV), and an estimated 80 million people (1.1% globally) are chronically infected with hepatitis C virus (HCV). In 2015, more than 700 000 deaths were directly attributable to HBV, and nearly 500 000 deaths were attributable to HCV infection; 2-5% of HBV-infected people develop HCC per annum irrespective of the presence of cirrhosis, whereas 1-5% HCV-infected people with advanced fibrosis develop HCC per annum. The rapidly escalating global mortality related to HBV and HCV related viral hepatitis to be the 7th leading cause of death worldwide in 2013, from 10th leading cause in 1990. Australia, New Zealand, and Pacific Island Countries and Territories fall within the World Health Organization Western Pacific Region, which has a high prevalence of viral hepatitis and related morbidity, particularly HBV. Remarkably, in this region, HBV-related mortality is greater than for tuberculosis, HIV infection, and malaria combined. The region provides a unique contrast in viral hepatitis prevalence, health system resources, and approaches taken to achieve World Health Organization global elimination targets for HBV and HCV infection. This review highlights the latest evidence in viral hepatitis epidemiology and explores the health resources available to combat viral hepatitis, focusing on the major challenges and critical needs to achieve elimination in Australia, New Zealand, and Pacific Island Countries and Territories.


epidemiology; liver cancer; viral hepatitis


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