Infectious diseases - hepatitis A and B

What is hepatitis (types A and B)?

Introduction

Hepatitis is an inflammation of the liver and has numerous causes, including viral infection, alcohol or drug abuse, and the body's immune system attacking itself. It can be a short-term, acute illness or a persistent, chronic disease. A number of viruses are responsible for viral hepatitis, with types A, B, and C being the most common (types D through G have been identified also). Each virus causes a different manifestation of disease and each is transmitted in different ways.

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Hepatitis A

Cause - infection with the hepatitis A virus (HAV), an enterovirus transmitted principally through person-to-person contact, and also through food and water contaminated with faecal matter from an infected individual. Eating shellfish taken from contaminated water is another known route of infection.

Symptoms - typically mild, though often more serious in adults than children, symptoms can include fever, jaundice (yellowing of the skin and eyeballs), vomiting, and generalised aches. Infected individuals may also notice a darkening of the urine and pale-coloured stools.
Duration - symptoms typically improve within three weeks, but can persist for several months.

Prevention - a safe vaccine exists and is highly recommended for at-risk individuals, including those who travel and are exposed to water of questionable quality. Thorough handwashing with soap and warm water is the most effective preventive measure.

Treatment - no specific treatment exists.

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Hepatitis B

Cause - infection with the hepatitis B virus (HBV). Transmission occurs due to contact with blood and other body fluids (semen, vaginal fluids, and saliva) from an infected individual, commonly through sexual contact or use of contaminated injecting equipment. A mother may also transmit HBV to the foetus during pregnancy.

Symptoms - only one-third of people acutely infected with HBV will experience obvious symptoms, including jaundice, loss of appetite and mild flu-like symptoms, including fever, fatigue, headache, nausea, and vomiting. HBV can cause a more prolonged illness in which a person may look and feel well, but slowly develop severe liver damage. Patients may develop pain in the joints, especially in the hands. The risk of developing cancer of the liver is also increased in people with chronic HBV infection. Carriers of HBV may also become infected with the hepatitis D virus (HDV) through similar methods, which increases the probability of dramatic damage to the liver.

Duration - HBV infection can last for a variable amount of time, depending on how well the body is able to fight off the infection. Approximately 90 percent of adults will recover spontaneously within 6 months. Infected individuals can become 'carriers' - people with long term infections but few symptoms. This occurs in approximately 10% of adults infected and up to 90% of infants. About one-quarter of those who become carriers will develop chronic liver disease.

Prevention - a number of safe and effective vaccines exist for protection against HBV infection and may be provided free of charge. Vaccination is recommended for all infants at birth. Additionally, safe sex precautions should always be taken, especially the use of a lubricated latex condom during each sexual encounter. Injecting equipment, razors, or any other objects that may contact another person's blood should never be shared.

Treatment - primarily designed to reduce liver damage or boost the body's natural defences. Treatments for chronic HBV infection include the drug known as Interferon, sometimes used in combination with other drugs, especially ribavarin. Acute HBV infection has no treatment, but in both acute and chronic conditions it is important for the patient to limit alcohol consumption to one or fewer drinks per day (preferably abstaining altogether) and avoid taking medications not specifically recommended by a physician.

This information was compiled with the help of a number of Fact Sheets available through various reliable sources including:
US Center for Disease Control and Prevention
WebMD
Hepatitis Foundation International

Hepatitis C

Expanded and updated information on hepatitis C has been compiled separately
View: what is hepatitis C?

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A brief summary of hepatitis among Indigenous Australians

Introduction

Hepatitis is responsible for a significant burden of ill-health for Aboriginal and Torres Strait Islander people. Hepatitis is an inflammation of the liver and has numerous causes, including viral infection, alcohol or drug abuse, and the body's immune system attacking itself. It can be a short-term, acute illness or a persistent, chronic disease.

There is little systematic information about non-viral hepatitis, but reasonable information is available for some jurisdictions for three of the types of hepatitis virus – hepatitis A, B and C – which are notifiable diseases. (There are a number of other types, including D and E, which are also notifiable diseases, and G, but detailed information is not available for infection with these viruses). Each virus causes a different manifestation of disease and each is transmitted in different ways.

Hepatitis A and B have traditionally been larger problems for the Indigenous community than for the non-Indigenous population of Australia [1]. Past studies have found infection rates to reach intermediate to high levels throughout Australia for both hepatitis A virus (HAV) and hepatitis B virus (HBV), according to World Health Organization (WHO) standards. Less is known about hepatitis C virus (HCV) infection, though it is not likely to be associated with Indigenous status per se, and is more closely correlated with injecting drug use.

National surveillance of viral hepatitis is coordinated by the National Centre in HIV Epidemiology and Clinical Research (NCHECR), based on information collected by state and territory health authorities [2]. Provision is made for the identification of Indigenous people in notifications of hepatitis A, B and C, but the levels of identification are generally quite poor. Western Australia (WA), South Australia (SA) and the Northern Territory (NT) are the only jurisdictions with consistently reasonable levels of identification, so the information presented here is restricted to those jurisdictions. (The results from a major recent review of bloodborne viruses, including HBV and HCV, among Indigenous people include notifications from all jurisdictions except the Australian Capital Territory, so are not comparable with the results presented here [3]).

It is difficult to determine the level of HCV infection among Indigenous Australians as Indigenous status is not stated in a high proportion of notifications from various states and territories [2]. However, evidence suggests that illicit drug use among Indigenous Australians is higher than among non-Indigenous Australians [4] and the Australian Hepatitis C Surveillance Strategy has identified Indigenous Australians as at higher risk of HCV transmission than the general population [5].

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Hepatitis A

Hepatitis A virus (HAV) presents a significant problem for many Indigenous communities as transmission is facilitated by environments with poor sanitation and inadequate water supply (problems for many Indigenous communities), and is exacerbated by the overcrowding (also common in many Indigenous communities) [6, 7].

Indigenous people, in urban communities as well as in rural areas, are at much greater risk of HAV infection than are non-Indigenous people [7] and become infected at much younger ages [8].

Hepatitis A is often asymptomatic, so the numbers of cases notified to health authorities underestimate its true extent [9]. Many of the cases notified are quite severe, and the virus has caused the death of six Indigenous children in North Queensland and Western Australia in recent years.

Based on the success of HAV vaccination program that began in North Queensland in February 1999 [10], the Australian Government has provided funding for HAV vaccination for Indigenous children in Queensland, WA and NT since 2005 [11]. Of course, preventive measures must not be limited to vaccination, but should include improvement of the environmental quality of Indigenous communities to reduce transmission rates [12].

Notifications of HAV

Of the 314 notifications of hepatitis A for people living in WA, SA, and the NT in 2004-2006, 105 (33%) were identified as being Indigenous (Indigenous status was not stated in 1% of cases) [Derived from 2, 5, 13]. The crude notification rate of 22 per 100,000 for Indigenous people was 11.5 times the rate of 1.9 per 100,000 for non-Indigenous people. The real incidence of hepatitis A among Indigenous people is probably much higher than these figures suggest, however, as the disease is endemic in many rural and remote communities [14].

A detailed study of clinically significant HAV infection found that the disease was much more common among Indigenous children than non-Indigenous children, particularly those living in the Northern Territory, Western Australia, South Australia and north Queensland [9]. Children aged 0-4 years are at greatest risk from HAV infection.

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Hepatitis B virus

Historical as well as more recent studies have consistently shown a higher prevalence of hepatitis B virus (HBV) infection in the Indigenous community than in the general population [15, 16]. Overall, Australia has a low prevalence of hepatitis B, but, prior to the introduction of HBV vaccination, the Indigenous population had levels comparable with countries with the highest prevalence of HBV infection [17].

Transmission of HBV occurs due to contact with blood and other body fluids (semen, vaginal fluids, and saliva) from an infected individual, commonly through sexual contact or use of contaminated injecting equipment [18]. A mother may also transmit HBV to the foetus during pregnancy. Only one-third of people acutely infected with HBV will experience obvious symptoms, including jaundice, loss of appetite and mild flu-like symptoms, but the virus can cause a more prolonged illness in which a person may look and feel well, but slowly develop severe liver damage. The risk of developing cancer of the liver is also increased in people with chronic HBV infection.

A universal vaccination program started in the Indigenous community in 1988 has had considerable success [19], but some studies suggest that Indigenous children had a sub-optimal response to the HBV vaccine more often than their non-Indigenous counterparts [20]. Possible explanations for the inefficiency of the vaccine include a failure in the cold-chain, genetic differences (specifically in the major histocompatability complex, or MHC), or extrinsic environmental factors, such as heavy smoking among pregnant women. HBV vaccination programs are nevertheless cost-effective and relatively successful and help reduce the levels of hepatitis B infection in the Indigenous community.

Notifications of HBV

Of the 157 notifications of hepatitis B for people living in WA, SA, and the NT in 2004-2006, 30 (19%) were identified as being Indigenous (Indigenous status was not stated in 23% of cases) [Derived from 2, 5, 13]. The crude notification rate of 6.3 per 100,000 for Indigenous people was 5.5 times the rate of 1.1 per 100,000 for non-Indigenous people.

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Hepatitis C virus

Transmission of hepatitis C virus (HCV) typically occurs via blood-to-blood contact [21]. Injecting drug use (IDU) is the most common method of contracting the virus and is responsible for the vast majority of cases.

Many people who are infected with HCV do not have symptoms with the virus frequently being detected through a blood test for some reason [21]. Persistence of HCV in the body, which occurs in about 80% of cases, can cause cirrhosis (permanent scarring of the liver). Chronic HCV infection is generally asymptomatic until cirrhosis has developed.

There is no vaccine or cure for HCV, but some people with HCV benefit from treatment with interferon alpha or a combination of interferon alpha and ribavirin [21].

Notifications of HCV

Of the 6012 notifications of hepatitis C for people living in WA, SA, and the NT in 2004-2006, 658 (11%) were identified as being Indigenous (in 23% of notifications, Indigenous status was not stated) [Derived from 2, 5, 13]. The crude notification rate of 138 per 100,000 for Indigenous people was 3.6 times the rate of 38 per 100,000 for Indigenous people.

Conclusion

Infection with hepatitis virus is much more common among Indigenous people than among non-Indigenous people. ‘Closing the gap’ between Indigenous and non-Indigenous rates will require concerted efforts to increase HAV and HBV vaccination among susceptible Indigenous populations, and ensuring physical environments that do not facilitate spread of the disease. Culturally appropriate initiatives to decrease injecting drug use rates among Indigenous people will help to lessen infection with HCV.

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References

1 Burns J, Burrow S, Genovese E, Pumphrey M, Sims E, et al.(2003) Other communicable diseases. In: Thomson N, ed. The health of Indigenous Australians. South Melbourne: Oxford University Press:397-441
2 National Centre in HIV Epidemiology and Clinical Research (2007) HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia. (AIHW catalogue no. PHE 92) Darlinghurst, NSW: National Centre in HIV Epidemiology and Clinical Research
3 National Centre in HIV Epidemiology and Clinical Research (2007) Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander people:surveillance report 2007. Darlinghurst, NSW: National Centre in HIV Epidemiology and Clinical Research
4 Australian Institute of Health and Welfare (2007) Statistics on drug use in Australia 2006. (AIHW catalogue no. PHE 80) Canberra: Australian Institute of Health and Welfare
5 National Centre in HIV Epidemiology and Clinical Research (2006) HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia. (AIHW catalogue no. PHE 78) Darlinghurst, NSW: National Centre in HIV Epidemiology and Clinical Research
6 Schultz R (2005) Hepatitis A outbreak in Central Australia. Northern Territory Disease Control Bulletin;12(4):4-7
7 Clementson C (2005) Contemporary issues in Aboriginal and Torres Strait Islander health: HIV, hepatitis and sexual health. Darlinghurst, NSW: Australasian Society for HIV Medicine
8 McCaughan GW, Torzillo PJ (2000) Hepatitis A, liver transplants and Indigenous communities [editorial]. Medical Journal of Australia;172:6-7
9 MacIntyre C, Burgess M, Isaacs D, McIntyre P, Menzies R, et al. (2007) Epidemiology of severe hepatitis A in Indigenous Australian children. Journal of Paediatrics and Child Health;43:383-387
10 Hanna JN, Hills SL, Humphreys JL (2004) Impact of hepatitis A vaccination of Indigenous children on notifications of hepatitis A in north Queensland. Medical Journal of Australia;181(9):482-485
11 Australian Department of Health and Ageing (2005) Aboriginal and Torres Strait Islander People. Retrieved 8 February from http://www.health.gov.au/internet/immunise/publishing.nsf/Content/atsi
12 Hanna JN, Warnock TH, Shepherd RW, Selvey LA (2000) Fulminant hepatitis A in Indigenous children in north Queensland. Medical Journal of Australia;172:19-21
13 National Centre in HIV Epidemiology and Clinical Research, Australian Institute of Health and Welfare (2005) HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2005. (AIHW catalogue no. PHE 64) Sydney: National Centre in HIV Epidemiology and Clinical Research and the Australian Institute of Health and Welfare
14 Merritt A, Symons D, Griffiths M (1999) The epidemiology of acute hepatitis A in north Queensland, 1996-1997. Communicable Diseases Intelligence;23(5):120-124
15 Barrett EJ (1976) Hepatitis B in Australian Aborigines and Torres Strait Islanders: geographical, age and familial distribution of antigen subtypes and antibody. Australian and New Zealand Journal of Medicine;6(2):106-11
16 Wood N, Backhouse L, Gidding HF, Gilbert GL, Lum G, et al. (2005) Estimates of chronic hepatitis B virus infection in the Northern Territory. Communicable Diseases Intelligence;29(3):289-290
17 Kaldor J, Plant A, Thompson S, Longbottom H, Rowbottom J (1996) The incidence of hepatitis B infection in Australia: an epidemiological review. Medical Journal of Australia;165(6):322-326
18 MedlinePlus (2008) Hepatitis B. Retrieved 9 February 2008 from http://www.nlm.nih.gov/medlineplus/ency/article/000279.htm
19 Sullivan JS, Hanna JN (1999) A genetic marker associated with non-response to recombinant hepatitis B vaccine by indigenous Australian children [letter]. Journal of Paediatrics and Child Health;35(4):412-3
20 Hanna J, Faoagali J, Buda P, Sheridan J (1997) Further observations on the immune response to recombinant hepatitis B vaccine after administration to Aboriginal and Torres Strait Island children. Journal of Paediatrics and Child Health;33(1):67-70
21 MedlinePlus (2008) Hepatitis C. Retrieved 9 February 2008 from http://www.nlm.nih.gov/medlineplus/ency/article/000284.htm

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Policies and strategies

2005

Commonwealth of Australia (2005)
National Aboriginal and Torres Strait Islander sexual health and blood borne virus strategy 2005-2008.
Canberra: Commonwealth of Australia
View HealthInfoNet abstract
View report (HTML)
View report (PDF - 2MB - large file warning!)

Department of Health (2005)
Hepatitis B vaccination policy.
North Sydney: NSW Health
View report (PDF - 116KB)

2003

Fisher DA, Huffam SE (2003)
Management of chronic hepatitis B virus infection in remote-dwelling Aboriginals and Torres Strait Islanders: an update for primary healthcare providers.
Medical Journal of Australia;178(2):82-85
View paper (HTML)
View paper (PDF)

2000

Department of Health (2000)
Queensland health policy for hepatitis B immunisation.
Brisbane: Queensland Health
View report (PDF - 32KB)

Prior to 2000

Royal Australian College of General Practitioners (1994)
Hepatitis B immunisation.
South Melbourne: Royal Australian College of General Practitioners
View report (HTML)

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Guidelines

2005

Victorian Government Department of Human Services (2005)
The blue book. Guidelines for the control of infectious diseases.
Melbourne: Department of Human Services
View guidelines (PDF - 1.0MB - large file warning!)

2004

Davis JS, Currie BJ, Fisher DA, et al. (2004)
Prevention of opportunistic infections in immunosuppressed patients in the tropical Top End of the Northern Territory.
Northern Territory Disease Control Bulletin;11(1):7-13
View guidelines (PDF)

2003

Fisher DA, Huffam SE (2003)
Management of chronic hepatitis B virus infection in remote-dwelling Aboriginals and Torres Strait Islanders: an update for primary healthcare providers.
Medical Journal of Australia;178(2):82-85
View guidelines (HTML)
View guidelines (PDF)

2001

Queensland Health (2001)
Guidelines for implementation of Queensland health policy for hepatitis B (HBV) immunisation in relation to health care workers.
Brisbane: Queensland Government
View guidelines (PDF - 84KB)

2000

Centre for Disease Control (2000)
Northern Territory hepatitis A vaccination policy and public health management guidelines.
Casuarina: Territory Health Services, Northern Territory Government
View guidelines (PDF)

Centre for Disease Control (2000)
Northern Territory hepatitis B vaccination policy and public health management guidelines.
Casuarina: Territory Health Services, Northern Territory Government
View guidelines (PDF)

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Programs and projects

Royal Brisbane Hospital Research Foundation, Clinical Research Centre
Provides a summary of projects carried out by the Hepatitis and Liver Disease Unit, including the 'Phylogenetic analysis of Australian Aboriginal HBV strains and their relationship with other published sequences'.
View project information

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Health promotion resources

Australian Federation of AIDS Organisations (2004)
Sistergirls say - keep yourself covered (poster).
Canberra: Australian Federation of AIDS Organisations

The Australian Federation of AIDS Organisations (AFAO) launched two national peer-based posters in Sydney on 30 October 2004, as a health promotion resource for Aboriginal and Torres Strait Islander Sistergirls. The posters were designed to: empower Indigenous Sistergirls and transgender communities by raising HIV/AIDS awareness; address underlying issues such as isolation and discrimination; and promote positive self-esteem which in turn promotes individuals to engage in safer sexual practices, such as condom usage. The posters were developed in response to the National Indigenous gay and transgender consultation report and sexual health strategy, as was the AFAO strategy for responding to sexual abuse of young Aboriginal and Torres Strait Islander gay men and Sistergirls.

Australian Indigenous HealthInfoNet abstract

The National Indigenous gay and transgender consultation report and sexual health strategy (PDF - 208KB), and the AFAO strategy for responding to sexual abuse of young Aboriginal and Torres Strait Islander gay men and Sistergirls (PDF - 2MB - large file warning!), can be accessed online at the AFAO website.

For further information about the posters or to obtain copies visit the AFAO website, or contact:Australian Federation of AIDS Organisations, Level 1, 222 King Street, Newtown NSW 2042; PO Box 51, Newtown NSW 2042; ph: (02) 9557 9399, fax: (02) 9557 9867.

Australasian Society for HIV Medicine (ASHM) (2004)
Talking together: contemporary issues in Aboriginal and Torres Strait Islander health: HIV, Hepatitis and Sexual Health. A distance learning package for those working in Indigenous health.
Darlinghurst, NSW: Australasian Society for HIV Medicine (ASHM)

This resource was developed in collaboration with the Indigenous Australians' Sexual Health Committee (IASHC) and funded by the Office for Aboriginal and Torres Strait Islander Health (OATSIH), Department of Health and Ageing. It was designed for use by general practitioners and other interested clinicians and health care workers. The package contains a copy of the video (a CD version is available) 'Talking Together', a users guide with training materials and activities, and a copy of the ASHM monograph HIV/Viral Hepatitis - a guide for primary care. The manual offers practical advice for risk assessment, testing, diagnosis, and basic principles of management of HIV and viral hepatitis. The incorporation of viral hepatitis reflects the trends in public policy and medical practice towards locating HIV/AIDS within the broader public health and sexual health context.

Australian Indigenous HealthInfoNet abstract

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Lessons learned

Menzies R, McIntyre P, Beard F (2004)
Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia, 1999 to 2002.
Communicable Diseases Intelligence;28(2):127-159
View HealthInfoNet abstract

Case studies

Currently no information collected

Evaluations

Hanna JN, Hills SL, Humphreys JL (2004)
Impact of hepatitis A vaccination of Indigenous children on notifications of hepatitis A in north Queensland.
Medical Journal of Australia;181(9):482-485
View full paper (HTML)
View full paper (PDF)

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Published resources

Journal articles

2007

MacIntyre CR, Burgess M, Isaacs D, MacIntyre PB, Menzies R, et al. (2007)
Epidemiology of severe hepatitis A in Indigenous Australian children.
Journal of Paediatrics and Child Health;43(5):383-387
View abstract: Journal of Paediatrics and Child Health
View website: Blackwell Synergy

Schultz R (2007)
Hepatitis B screening among women birthing in Alice Springs Hospital, and immunisation of infants at risk.
Northern Territory Disease Control Bulletin;14(2):1-5
View article (PDF - 382KB)
View website: Department of Health and Community Services

2005

Anonymous (2005)
New Commonwealth funding for Hepatitis A vaccine for Indigenous children.
The Northern Territory Communicable Diseases Bulletin;12(2):21
View paper (PDF)

Wood N, Backhouse J, Gidding HF, Gilbert GL, Lum G, McIntyre PB (2005)
Estimates of chronic hepatitis B virus infection in the Northern Territory.
Communicable Diseases Intelligence;29(3):289-90
View paper (HTML)
View paper (PDF - 27KB)

Wright MR, Giele CM, Dance PR, Thompson SC (2005)
Fulfilling prophecy?: sexually transmitted infections and HIV in Indigenous people in Western Australia.
Medical Journal of Australia;183(3):124-128
View paper (HTML)
View paper (PDF)

2004

Hanna JN, Hills SL, Humphreys JL (2004)
Impact of hepatitis A vaccination of Indigenous children on notifications of hepatitis A in north Queensland.
Medical Journal of Australia;181(9):482-485
View paper (HTML)
View paper (PDF)

Maher L, Chant K, Jalaludin B, Sargent P (2004)
Risk behaviors and antibody hepatitis B and C prevalence among users in south-western Sydney, Australia.
Journal of Gastroenterology and Hepatology;19(10):1114-1120
View abstract (HTML)

Menzies R, McIntyre P, Beard F (2004)
Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia, 1999 to 2002.
Communicable Diseases Intelligence;28(2):127-159
View HealthInfoNet abstract

2003

Fisher DA, Huffam SE (2003)
Management of chronic hepatitis B virus infection in remote-dwelling Aboriginals and Torres Strait Islanders: an update for primary healthcare providers.
Medical Journal of Australia;178(2):82-85
View paper (HTML)
View paper (PDF)

2000

Hanna JN, Warnock TH, Shepherd RW, Selvey LA (2000)
Fulminant hepatitis A in Indigenous children in north Queensland.
Medical Journal of Australia; 172:19-21
View paper (HTML)

McCaughan GW, Torzillo PJ (2000)
Hepatitis A, liver transplants and Indigenous communities.
Medical Journal of Australia; 172:6-7
View paper (HTML)

Prior to 2000

Butler TG, Dolan KA, Ferson MJ, McGuinness LM, Brown PR, Robertson PW (1997)
Hepatitis B and C in New South Wales prisons: prevalence and risk factors.
Medical Journal of Australia;166:177
View paper (HTML)

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Reports

2007

Kwan K, Combs B, Mak D, Giele C, Ferguson C, et al. (2007)
Epidemiology of notifiable sexually transmitted infections and blood-borne viruses in Western Australia 2006.
Perth: Communicable Disease Control Directorate, Department of Health, Western Australia
View report (HTML)
View website: Department of Health, Western Australia

2005

Australian Institute of Health and Welfare, Australian Bureau of Statistics (2005)
The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples.
Canberra: Australian Institute of Health and Welfare
View download information (HTML)
View health risk factors section (PDF - 308KB)

National Centre in HIV Epidemiology and Clinical Research (2005)
HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2005.
Sydney: National Centre in HIV Epidemiology and Clinical Research
View report (PDF - 1.9MB)

Miller M, Roche P, Yohannes K, et al. (2005)
Australia's notifiable diseases status, 2003: annual report of the National Notifiable Diseases Surveillance System.
Communicable Diseases Intelligence;29(1):1-60
View HealthInfoNet abstract
View report (PDF - 1.6MB - large file warning!)
View website

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2004

National Centre in HIV Epidemiology and Clinical Research (2004)
HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2004.
Sydney: National Centre in HIV Epidemiology and Clinical Research
View report (PDF - 699KB)

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Theses

Butler T (2001) 'Owned by nobody': health status and its determinants among New South Wales prisoners. Unpublished Doctor of Philosophy thesis, School of Community Medicine, University of New South Wales, Sydney.
View abstract (Australian Digital Thesis Program)
View full thesis (PDF - 1.9MB - large file warning!)

Wan X (1994)
Epidemiology of hepatitis B infection in the Northern Territory of Australia.
Unpublished Doctor of Philosophy thesis, University of Sydney, Sydney
View abstract

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Key references

  • ANCARD Working Party on Indigenous Australians' Sexual Health (1997) The National Indigenous Australians' sexual health strategy 1996-97 to 1998-99. A report of the ANCARD working party on Indigenous Australian's sexual health. Canberra, Commonwealth Department of Health and family Services, Australian Government Publishing Services.
  • Bowden F, Currie B, et al. (1994) Should Aboriginals in the Top End of the Northern Territory be vaccinated against hepatitis A? Medical Journal of Australia 161: 372-373.
  • Gardner I, Wan X, et al. (1990) Hepatitis B in Aboriginal Australians. Today's Life Science (16 September): 16-22.
  • Hanna J N, Warnock TH, et al. (2000) Fulminant hepatitis A in Indigenous children in north Queensland. Medical Journal of Australia 172: 19-21.
  • Henderson G, McKenna P, et al. (1995) Incident cases of Hepatitis A in the Torres Strait area during the period 1984-1994, and their relationship to rainfall [abstract]. Australian Epidemiological Association Annual Conference, Cairns
  • McCaughan G W, Torzillo PJ (2000) Hepatitis A, liver transplants and Indigenous communities. [editorial] Medical Journal of Australia 172: 6-7.
  • National Centre in HIV Epidemiology and Clinical Research (2000) HIV/AIDS, hepatitis C and sexually transmissible infections in Australia. Annual surveillance report 2000. Sydney, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales.
  • Plant A (1991) Hepatitis B, Aborigines and the Northern Territory: a public health perspective. [abstract]. Australian and New Zealand Journal of Medicine 21(4, Supplement 2, Proceedings of Meeting of Special Societies).
  • Thomson N, Honari, M (1988) A review of hepatitis B infection among Aborigines. Aboriginal Health Information Bulletin 9: 24-28
  • Thorpe A, Van der Sterren A (2000) The Victorian Aboriginal Health Service injecting drug use project - a harm minimisation project in the Melbourne Koori community. National Health Promotion Conference Inequalities in Health - reflecting back, stepping forward, Melbourne, Australia, Australian Health Promotion
  • Wan X (1994) Epidemiology of hepatitis B infection in the Northern Territory of Australia. Unpublished PhD thesis. Sydney, University of Sydney.

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Bibliography

If you have access to EndNote bibliographic software you may download our hepatitis EndNote library containing references from the Australian Indigenous HealthInfoNet bibliographic database about various types of hepatitis. If you use Netscape Navigator as your browser click the right mouse button and choose the 'save link as' option to save to your computer. If you use Internet Explorer you should choose the 'save target as' option.

Download hepatitis Endnote library (162KB - compiled April 2007)

If you do not have EndNote you may view the associated reference lists:
View hepatitis reference list (Word doc - 69KB - compiled April 2007)
View hepatitis reference list (PDF - 57KB - compiled April 2007)

Alternatively you may wish to search through the HealthInfoNet bibliographic database for references about hepatitis A and/or B.

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Organisations

National

Immunise Australia Program
Department of Health and Aged Care

Southern Queensland Rural Division of General Practice
Department of Health and Aged Care; immunisation site

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International

American Association for the Study of Liver Diseases
An organisation aimed at meeting the educational and scientific needs doctors, researchers, and scientists worldwide. Site includes links to practice guidelines and the latest information on research being conducted to prevent and cure liver disease.

American Liver Foundation
Link to liver health information, current news, coming events and archives.

Centers for Disease Control, Hepatitis Branch
Useful link to brochures, slides, publications

CDC Hepatitis Immunization Hotline
Information on hepatitis immunisation, and vaccine recommendations and safety is available here.

Food and Drug Administration (FDA)
Current vaccine information

Hepatitis B Foundation
Foundation with the aim of eliminating hepatitis B through public education and cure research programs.

Hepatitis Foundation International
The foundation seeks to increase awareness of the worldwide problem of viral hepatitis. Their link has useful information to educate the public and healthcare professionals about hepatitis prevention, diagnosis, and treatment.

Hepatitis Information Network
This site has facts on hepatitis A, B, C, D and E. Research articles, helpful tips for carriers, recent statistics, and vaccination information, is all available at this link.

Immunization Action Coalition
This site has immunisation information and hepatitis B educational materials.

National Foundation for Infectious Diseases
The information found at this site aids in the understanding of the causes, cures, and prevention of infectious diseases.

World Health Organisation (WHO)
This link provides an overview of hepatitis, and includes a glossary and list of related references.

Expanded and updated information on hepatitis C has been compiled separately
View hepatitis C: organisations

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Other information

Journals

Communicable Diseases Intelligence (CDI)
CDI is a quarterly publication of the Surveillance Section, Communicable Diseases and Biosecurity Branch, Australian Government Department of Health and Ageing. CDI aims to disseminate information on the epidemiology and control of communicable disease in Australia by providing current surveillance intelligence on communicable diseases in Australia accompanied by interpretation and expert commentary, publishing articles describing communicable disease surveillance and control and communicable disease epidemiology in Australia, and publishing significant strategic documents relevant to the surveillance and control of communicable disease in Australia.
View journal

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Conference proceedings

Currently no information collected

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Other

Hepatitis B information and support list. This link provides resources and information to hepatitis B patients and/or their caregivers.

Hepatitis B notifications
Communicable Disease Network Australia
Department of Health and Aged Care

Hepatitis: knowledge, understanding and treatment
Get the basics about hepatitis A-C and a slideshow about the functions of the liver.

Policy for universal birth hepatitis B immunisation
Queensland Health

Expanded and updated information on hepatitis C has been compiled separately
View hepatitis C: other information

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Related HealthInfoNet pages

For information on related health conditions and behaviours view the following HealthInfoNet webpages:

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You can contribute to improving the health of Australia's Indigenous people by assisting the HealthInfoNet's work
Last updated: 2 June 2008