Understanding viral hepatitis interventions in NSW at a population level
Surveillance of hospitalisations, antiviral therapy, hepatocellular carcinoma, and mortality among people diagnosed with hepatitis C or hepatitis B virus infection in New South Wales
In Australia, hepatitis B (HBV) and hepatitis C (HCV) infections cause significant morbidity, mortality, and healthcare costs. While effective treatments exist, including new highly efficacious HCV therapies (>90% cure rates) and evolving HBV treatments, there is a critical need to understand how these interventions are performing at a population level.
This project addresses key surveillance and research objectives from NSW's Hepatitis Strategies by establishing a comprehensive monitoring system to evaluate treatment outcomes, identify at-risk populations, and assess COVID-19's impact on care delivery. Understanding these patterns is essential for reducing disease burden and informing targeted interventions for those most affected.
This population-based linkage study addresses the significant health burden of hepatitis B (HBV) and hepatitis C (HCV) in New South Wales by establishing a comprehensive surveillance system. By linking 16 different healthcare and administrative datasets for all notified cases from 1993-2023, the project uniquely tracks patient outcomes, treatment uptake, and mortality rates across diverse populations. The study is distinctive in its extensive data integration and focus on marginalised populations groups in NSW. This approach enables evaluation of treatment effectiveness, identification of at-risk populations, and assessment of COVID-19's impact on hepatitis care, ultimately informing evidence-based health policies.
This project employs a population-based cohort design linking to multiple datasets, including hospital records, cancer registries, mortality data, opioid agonist therapy authority data, perinatal data, HIV registry, incarceration records, mental health ambulatory data, MBS/PBS data and social services information for all HBV/HCV notifications in NSW (1993-2023).
Two major data linkages will occur: a focused linkage in 2020 examining hospital records and mortality, followed by a comprehensive linkage in 2023 incorporating all datasets. The methodology uses time-to-event analysis and interrupted time series to evaluate testing and treatment outcomes, hospitalisation trends, mortality rates, and COVID-19's impact. Success will be measured through assessment of morbidity/mortality trends, treatment uptake patterns, and identification of risk factors across key populations, particularly marginalised populations.
This project will significantly impact public health by providing comprehensive surveillance of HBV/HCV outcomes in NSW, directly supporting the state's 2025-2030 Hepatitis Strategy. The study's extensive data linkage will identify populations at highest risk for poor outcomes and treatment barriers, enabling targeted interventions.
Healthcare providers and policymakers will benefit from evidence-based insights to improve treatment access and effectiveness, particularly for marginalised and underserved populations including women, Aboriginal and Torres Strait islander peoples, people who are incarcerated, people who inject drugs, rural Australians, people receiving social services support, people experiencing homelessness and/or mental health comorbidities. The inclusion of COVID-19 impact analysis will inform future pandemic response strategies for chronic disease management. Most importantly, findings will guide policy reforms to reduce the overall hepatitis burden in NSW.
- NSW Health
- Ministry of Health
- Doherty Institute
NSW Health
