Hepatitis B prevention in Victoria, Australia - the potential to protect

People with chronic hepatitis B (CHB) are a major source of incident hepatitis B virus (HBV) infection. The Department of Health in Victoria, Australia, recommends household contacts of CHB cases to be screened and funds hepatitis B vaccination for those susceptible to infection. In July 2009, two cross-sectional surveys were conducted to assess the uptake of screening and vaccination: a postal survey of the treating doctors of a random sample of 65 CHB patients and a telephone survey of these patients. Twenty-six cases reported all adult household contacts had been screened, however only eight of these 26 patients reported that all susceptible adult contacts had been fully vaccinated. In contrast, child contacts of only three cases had been screened but 15 reported all child contacts to be fully vaccinated. Half of the surveyed doctors were unaware of state-funded hepatitis B vaccine for contacts and only 10 had conducted any contact tracing. This study highlights the need for health departments to play a greater role in the management of CHB patients in order to support doctors' delivery of preventive services to people at high risk of HBV infection. These findings are relevant for all countries receiving immigrants from areas where hepatitis B is endemic.