Hepatitis B in Australia - Easier to Prevent than to Cure - Assignment Example

? Hepatitis B in Australia Introduction Hepatitis B is a disease caused by the hepatitis B virus that affectsthousands of people across the globe; it can become a life-threatening ailment if not properly managed. (Lai & Locarnini 2008) An individual who has contracted the hepatitis B virus is likely to suffer from liver cirrhosis or liver cancer, which might lead to death in most cases. Patients usually become weak, the immunity level reduces and as such they are prone to other health complications. The death rate resulting from this ailment is quite high and sound prevention and treatment measures need to be implemented (Fiorino, 2008) A vaccine against the disease was developed in the early 1980’s, and it has been in the market up to date; the efficiency of the vaccine against the disease is estimated to be about 95 per cent. A large part of those infected by the disease comes from Australia and the surrounding regions; therefore, this paper will discuss hepatitis B in Australia, namely, the causes, signs and symptoms, the economic impact of the disease and some of the measures that the local authorities apply to manage hepatitis B (Jenkins, 2010). Historical Development and Distribution of Hepatitis The earliest information that is available on hepatitis B goes back to 1885, when an epidemic of small pox ensued in Bremen, Germany, whereby 1289 shipyard workers who contracted the disease were immunized with lymph. Few weeks later some of the people that underwent immunization procedure had contracted jaundice and had serum hepatitis. After World War II, clinical and epidemiological studies differentiated between several types of acute hepatitis; for example, the research of Krugman and his colleagues in 1967 discovered at least two types of hepatitis, one of them being serum hepatitis, which was later named hepatitis B. From serological studies conducted by Prince, Blumberg and several of their colleagues, the virus responsible for causing hepatitis B was identified. In addition Blumberg and his colleagues, while searching for serum protein polymorphisms linked to various diseases, identified an antigen in serum that was present in patients who suffered from leukaemia, leprosy and hepatitis (Cox & Owen, 2012). While still working at the National Health Institute NHI, Baruch Blumberg discovered the Australia antigen, which later came to be known as hepatitis B surface from antigen HBsAg that was common in patients suffering from leukaemia and Down’s syndrome (Horn & Hecht, 2011). Distribution of hepatitis B:   % of population positive for Infection   Area     HBsAg   anti-HBs   neonatal   childhood     Northern, Western, and Central Europe, North America, Australia       0.2-0.5     4-6     rare     infrequent   Eastern Europe, the Mediterranean, Russia and the Russian Federation, Southwest Asia, Central and South America         2-7       20-55       frequent       frequent   Parts of China, Southeast Asia, tropical Africa       8-20     70-95     very frequent     very frequent Table 1: prevalence of hepatitis B in various areas in Australia and parts of Asia (Rani, M, Yang, B & Nesbit, R., 2008). Causes of Hepatitis B Hepatitis B is caused by the hepatitis B virus (HBV), which mainly attacks the human liver; when the virus enters the liver, it causes inflammation in the lining leading to an individual having severe headaches, diarrhoea and high body temperature, which are the typical signs of hepatitis B infection (Acton, 2012). An individual can be infected with the hepatitis B virus if he comes into contact with the body fluids of an infected person, such as semen, vaginal secretions and mucus among other body fluid, which means that the virus can be sexually transmitted, and, thus, ultimate care is required not to contract the infection (Zhang, Zhang & Ye, 2008). Secondly, the virus can be transmitted through collective use of certain sharp objects needed in medical procedures, such as surgical blades and needles among others (Lai & Locarnini, 2008). In addition, hepatitis B can enter into the body of a person during childbirth or the process of breast-feeding when a mother can pass the virus to a child; the child comes into contact with body fluids during childbirth and due to minor injuries that the child may have or through breast milk, body fluids are suckled. There are two types of hepatitis B: one is acute hepatitis B, which lasts for a short period (in most cases it does not exceed 6-months' period); most of the people who get this type of hepatitis are adults who have never contracted hepatitis B in their childhood. Another type of hepatitis would be the chronic hepatitis, which has been found to last for a very long time and in some cases an individual may have the disease for the rest of his life; this type of hepatitis is caused by a weak immune system that is unable to stop hepatitis B virus from spreading (Tsai, 2010). Moreover, the second type of hepatitis mainly occurs in individuals who contracted the disease before they are 5 years of age and it is usually detected after she/he has stayed with it for a very long period, which may sometimes be more than 10 years (Acton, 2012) Signs and Symptoms of Hepatitis B Signs and symptoms of hepatitis B include flu-like symptoms, such as fatigue, common aches and pains, headaches and a high fever, loss of desire for food and weight loss; these symptoms generally stop between one to three months (Fiorino, 2008). Chronic hepatitis B, which usually lasts for a long time period compared to acute hepatitis (more than 6 months), can be characterised by some or all of the following signs and symptoms: feeling tired always, loss of desire for food, feeling sickly, stomach pains, muscular and joint aches and scratchy skin (Revill et al., 2007) Virulence Virulence of hepatitis B includes the overproduction of the soluble form of surface antigen HbsAg; the surface antigen increases into non-infectious structures that are not associated with the viral Ribonucleic Acid. These non-infectious structures bind the antibodies responsible for eliminating the disease therefore reducing the number of antibodies that are available to bind on the hepatitis B virus, in addition the affinity of the hepatitis B for liver cells also contributes to the virulence of the virus. Aetiology Hepatitis B virus is an enveloped, hepatotrophic and very infectious DNA virus that belong to the hepadnaviruses group, the outer envelope of the virus contains three surface antigens with S protein being the most abundant. Inside this envelop lies the viral nucleocapsid which contains partially double-stranded circular DNA that induce the cellular immune response of the host against the virus. The X protein in the virus is responsible for development of hepatocellular carcinoma while the DNA polymerase is responsible for reverse-transcriptase function that synthesises negative and positive strands of hepatitis B virus DNA. Factors Complicating Management of Hepatitis B Numerous pathological reasons influence the reaction to IFN treatment; most of these reasons cannot be altered to change long-term results for better, and as such pointing out risk-increasing dynamics and quantifying spread of the virus early may help in determining the reaction of the therapy to modify or stop the therapy in timely manner (Calabresi, 2010; Choe et al., 2010). The treatment using this approach has produced positive results in victims who show insufficient response to the typical IFN treatment, especially among the patients who have shown relapse (Clements et al., 2010; Wallace, Richmond, McNally & La Trobe University, 2007; Chang et al., 2007) Impact of Hepatitis B in Australia Indirect Costs The indirect costs of HBV originate from the loss of healthy time to dedicate to work and relaxation and encompasses losses arising from premature death, loss of workplace productivity that can manifest itself not only in time off work but also in impaired productivity while at work. Costs that cannot be directly attributable to the disease were found to amount to 20.9% of the total societal expenses associated with the disease (Benson & Donohue, 2007). Quality of Life Studies on morbidity use Frailty-Adjusted Life Years (DALYs) as a metric to quantify the reduction in the living years due to death and debility caused by an ailment (Jenkins, 2010). How the Local Broadcasting Portrayal of the Disease Impact on People’s Perceptions and the Economy in General The local media have been on the forefront of campaigning against the disease and have portrayed hepatitis B as a killer disease (Benson & Donohue, 2007). The stigma that has been formed around hepatitis B has made people suffering from the disease to abstain from seeking medical attention, which consequently has led to the economy incurring huge cost in treating the disease at an advanced stage (Choe et al, 2006). On the other hand, the mass media have played a significant part in enlightening the citizens on the prevalence of the disease and the best ways to prevent or treat it (Tsai, 2010). Policies and Practices in Hepatitis B Management within the Local Authorities The medications used to treat hepatitis B have been improving alongside the technological development; currently, there are seven therapeutic agents approved by the Food and Drug Administration to manage chronic hepatitis B and reduce the quantity of those who suffer from the disease (Rani, Yang & Nesbit, 2008). These new agents have been proven to be capable to effectively spot hepatitis B virus in DNA, which at times is not detectable (Wallace & Australian Research Centre in Sex, Health and Society, 2012) In order to prevent the transmission of hepatitis B virus, several measures have been put in place to reduce the rates of infection, especially in health care settings; these measures include vaccination of health personnel in medical institutions to avoid them from contracting the virus when they come into contact with infected persons (Queensland Health, 2011). To ensure that people stay healthy, measures to encourage people to be tested for the virus during the early stages have also been launched, since the disease is more manageable in the initial stages as compared to those when it is fully developed. This strategy has been realized through public education programs, especially in the rural areas (Zoulim, 2011). On the other hand, to avoid transmission through sexual intercourse, use of protection, especially when the partners do not know the health status of each other, is encouraged and, finally, pregnant women who are about to give birth are advised to seek the services of experienced health practitioners to avoid mother-to-child transmissions (Weinbaum et al., 2008). References Acton, Q. A. (2012). Chronic Hepatitis B virus: New insights for the healthcare professional. 2012 Edition: Scholarly Brief. Scholarly Editions. Benson, J., & Donohue, W. (2007). Hepatitis in refugees who settle in Australia. Australian Family Physician, 36, 9, 719-27. Calabresi, L. (2010). Navigating hepatitis B. Australian Doctor, Retrieved from http://search.proquest.com/docview/195140423?accountid=45049 Chang, J. J., Thompson, A. J., Visvanathan, K., Kent, S. J., Cameron, P. U., Wightman, F., Desmond, P., ... Lewin, S. R. (2007). The phenotype of hepatitis B virus-specific T cells differs in the liver and blood in chronic hepatitis B virus infection. Hepatology (baltimore, Md.), 46(5), 1332-40. Choe, J. H., Taylor, V. M., Yasui, Y., Burke, N., Nguyen, T., Acorda, E., & Carey Jackson, J. (2006). Health care access and sociodemographic factors associated with hepatitis B testing in vietnamese American men. Journal of Immigrant and Minority Health, 8(3), 193-201. Retrieved from http://dx.doi.org/10.1007/s10903-006-9322-1. Clements, C. J., Coghlan, B., Creati, M., Locarnini, S., Tedder, R. S., & Torresi, J. (2010). Global control of hepatitis B virus: Does treatment-induced antigenic change affect immunization? World Health Organization.Bulletin of the World Health Organization, 88(1), 66-73. Retrieved from http://search.proquest.com/docview/229599277?accountid=45049 Cox, J. T., & Owen, D. I. (2012). Hepatitis B: New research. Hauppauge, N.Y: Nova Science. Fiorino, S. (2008). Hepatitis B virus and immune response. New York: Nova Science Publishers. Horn, L. W., & Hecht, A. (2011). Hepatitis. New York: Chelsea House. Jenkins, R. (2010). Chronic hepatitis B prevalence on the rise. Australian Doctor, Retrieved from http://search.proquest.com/docview/195143724?accountid=45049 Lai, C. L., & Locarnini, S. (2008). Hepatitis B virus. London: International Medical Press. Queensland Health. (2011). Hepatitis B in Queensland: A situation analysis, May 2011. Brisbane, Qld: Queensland Health. Rani, M, Yang, B & Nesbit, R. (2008). Hepatitis B control by 2012 in the WHO Western Pacific Region: rationale and implications. World Health Organisation, retrieved from < http://www.who.int/bulletin/volumes/87/9/08-059220/en/> Revill, P. A., Littlejohn, M., Ayres, A., Yuen, L., Colledge, D., Bartholomeusz, A., Sasaduesz, J. Locarnini, S. A. (2007). Identification of a novel hepatitis B virus precore/core deletion mutant in HIV/hepatitis B virus co-infected individuals. Aids (london, England), 21, 13, 1701-10. Tsai, N. C. S. (2010). Chronic hepatitis B: An update. Philadelphia, Pa: Saunders. Wallace, J., & Australian Research Centre in Sex, Health and Society. (2012). Investigating general practice and hepatitis B. La Trobe University, Vic: Australian Research Centre in Sex, Health & Society. Wallace, J., Richmond, J., McNally, S., & La Trobe University. (2007). National hepatitis B needs assessment 2007. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University. Weinbaum, C. M., Williams, I., Mast, E. E., Wang, S. A., Finelli, L., Wasley, A., Neitzel, S. M., National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (Centers for Disease Control and Prevention). (2008). Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. Atlanta, GA: Dept. of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. Zhang, X., Zhang, W., & Ye, L. (2008). Hepatitis B virus research focus. New York: Nova Biomedical Books. Zoulim, F. (2011). Antiviral therapy of chronic Hepatitis B virus infections: Is resistance still a challenge?. London: Henry Stewart Talks. Read More

 

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