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B Positive – all you wanted to know about - ASHM

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the implementation of hepatitis b prevention<br />

and education is crucial <strong>to</strong> increase public<br />

awareness of hepatitis b including the<br />

risk fac<strong>to</strong>rs for transmission, measures for<br />

prevention, and the availability of therapy.<br />

these programs should be designed<br />

specific<strong>all</strong>y for at-risk populations, such as<br />

caLd communities, the aboriginal and <strong>to</strong>rres<br />

strait islander populations, idus, MsM, and<br />

prisoners.<br />

the increasing number of people with chronic<br />

HbV infection and the improved availability<br />

of HbV therapy mandate an enhanced<br />

response <strong>to</strong> treatment and care. this response<br />

should include national guidelines for HbV<br />

diagnosis and moni<strong>to</strong>ring. the establishment<br />

of community hepatitis clinics and the<br />

enhancement of GP shared-care models in<br />

areas with large asian and aboriginal and <strong>to</strong>rres<br />

strait islander populations is also a priority.<br />

fin<strong>all</strong>y, barriers <strong>to</strong> health care service access<br />

among idus, MsM, caLd and aboriginal and<br />

<strong>to</strong>rres strait islander communities include<br />

stigma and discrimination related <strong>to</strong> high-risk<br />

behaviours, the lack of english proficiency,<br />

and cultural differences. therefore, besides<br />

providing training and essential information<br />

related <strong>to</strong> hepatitis b for primary care<br />

practitioners, improving their understanding<br />

of health beliefs, language difficulties, and the<br />

cultural attitudes of affected populations is also<br />

crucial <strong>to</strong> facilitating access <strong>to</strong> health services<br />

for at-risk groups.<br />

References<br />

1. World Health organization. Hepatitis b fact<br />

sheet no 204. 2000 [Last accessed september<br />

2006]; available from: http://www.who.int/<br />

mediacentre/factsheets/fs204/en/print.html<br />

2. World Health organization, department of<br />

communicable diseases surveillance and<br />

response. Hepatitis b; 2002. report no.:<br />

WHo/cds/csr/Lyo/2002.2.<br />

3. World Health organization. introduction<br />

of hepatitis b vaccine in<strong>to</strong> childhood<br />

immunisation services. report no.: WHo/<br />

V&b/01.31.Geneva; 2001.<br />

4. crawford dH, fawcett J. Hepa<strong>to</strong>cellular<br />

carcinoma in australia: largely preventable.<br />

Med J aust 2000; 173: 396-7.<br />

5. nguyen Vtt, razali K, amin J, Law MG, dore<br />

GJ. estimates and projections of hepatitis brelated<br />

hepa<strong>to</strong>cellular carcinoma in australia<br />

among people born in asia-Pacific countries.<br />

J Gastroenterol Hepa<strong>to</strong>l 2007. doi:10.1111/<br />

j.1440-1746.2007.05065.x<br />

6. o’sullivan bG, Gidding Hf, Law M, Kaldor<br />

JM, Gilbert GL, dore GJ. estimates of chronic<br />

hepatitis b virus infection in australia, 2000.<br />

aust nZ J Public Health 2004;28:212-6.<br />

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cossart ye. the current pattern of hepatitis<br />

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8. national notifiable diseases surveillance<br />

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9. roberts sK, Kemp W. Hepa<strong>to</strong>cellular<br />

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carcinoma in an australian tertiary referral<br />

hospital 1975-2002: change in epidemiology<br />

and clinical presentation. J Gastroenterol<br />

Hepa<strong>to</strong>l 2007;22:191-6.<br />

Mccaughan GW, Parsons c, G<strong>all</strong>agher nd. an<br />

australian experience of hepatitis b infection,<br />

cirrhosis and hepa<strong>to</strong>cellular carcinoma. ann<br />

acad Med singapore 1980;9:199-200.<br />

11. bor<strong>to</strong>lotti f, Jara P, crivellaro c, Hierro L,<br />

cadrobbi P, frauca e, et al. outcome of<br />

chronic hepatitis b in caucasian children<br />

during a 20-year observation period. J<br />

Hepa<strong>to</strong>l 1998;29:184-90.<br />

12. Law MG, roberts sK, dore GJ, Kaldor<br />

JM. Primary hepa<strong>to</strong>cellular carcinoma in<br />

australia, 1978-1997: increasing incidence<br />

and mortality. Med J aust 2000;173:403-5.<br />

13. amin, J., o’connell, d., bartlett, M., tracey,<br />

e., Kaldor, J., Law, M. & dore, G. (2007) Liver<br />

cancer and hepatitis b and c in new south<br />

Wales, 1990-2002: a linkage study. australian<br />

and new Zealand Journal of Public Health,<br />

31,475-482.<br />

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age standardised incidence rates nsW. in.<br />

sydney: nsW central cancer registry, 2007.<br />

b <strong>Positive</strong> <strong>–</strong> <strong>all</strong> <strong>you</strong> <strong>wanted</strong> <strong>to</strong> <strong>know</strong> <strong>about</strong> hepatitis b: a guide for primary care providers 19

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