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Preventing primary liver cancer: how well are we faring towards a national hepatitis B strategy?

Monica C Robotin, Jacob George, Rajah Supramaniam, Freddy Sitas and Andrew G Penman
Med J Aust 2008; 189 (4): . || doi: 10.5694/j.1326-5377.2008.tb02004.x
Published online: 18 August 2008

In reply: We agree with Awofeso that prisoners and Indigenous people have an increased risk of developing chronic hepatitis B. However, as no large-scale population-based studies of hepatitis B prevalence have been published in Australia, estimates of the risk vary widely.1 A national hepatitis B strategy may provide additional impetus for obtaining high-quality data. We also concur that modifiable behavioural factors may play a role in the age of hepatocellular carcinoma diagnosis, but differences in clinical course between Asian and white Australians,2 and the specific viral genotypes prevalent in Asia,3 are likely to be more important.


  • 1 Cancer Council New South Wales, Sydney, NSW.
  • 2 University of Sydney, Sydney, NSW.
  • 3 Westmead Hospital, Sydney, NSW.


Correspondence: monicar@nswcc.org.au

  • 1. O’Sullivan BG, Gidding HF, Law M, et al. Estimates of chronic hepatitis B virus infection in Australia, 2000. Aust N Z J Public Health 2004; 28: 212-216.
  • 2. Yuen MF. Revisiting the natural history of chronic hepatitis B: impact of new concepts on clinical management. J Gastroenterol Hepatol 2007; 22: 973-976.
  • 3. Keeffe EB, Dieterich DT, Han SH, et al. A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: an update. Clin Gastroenterol Hepatol 2006; 4: 936-962.
  • 4. Yuen MF, Yuan HJ, Hui CK, et al. A large population study of spontaneous HBeAg seroconversion and acute exacerbation of chronic hepatitis B infection: implications for antiviral therapy. Gut 2003; 52: 416-419.

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