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August - September 2007


Health

Raising awareness about hepatitis B

Thousands of Deaths from Hepatitis B Among London’s Ethnic Communities Could Be Prevented

Many thousands of deaths from hepatitis B among London’s ethnic communities could be prevented through improved education and destigmatising the disease, according to experts. This was the conclusion of a meeting involving representatives from London’s ethnic communities and media, organised in July by the B Aware Campaign to explore methods of effectively containing the spread of the virus amongst these high-risk populations.

“Hepatitis B is a very dangerous virus because it is a stealth virus that kills people slowly and does not advertise its presence”, explained Graham Foster, Professor of Hepatology at Barts and The London NHS Trust. “Children infected by their mothers with hepatitis B can grow up without knowing they are affected, providing plenty of opportunities to pass on the virus before they eventually die from liver disease, which is the fate of many of those infected.”

The meeting participants were told that the majority of these deaths can be prevented if the disease is detected early enough by testing those known to be particularly at risk. 90 per cent of babies infected by their mothers at birth will develop chronic hepatitis B,1 yet babies born to infected mothers can be effectively vaccinated just after birth. Infected adults can keep the levels of circulating virus in their body effectively under control with drug therapy – although once infected, they can never be completely cured.

London’s ethnic population is particularly at risk of hepatitis B infection, as many will have been born in areas of the world where the prevalence of hepatitis B is high, or born in the UK to infected mothers who themselves have come from these areas. They are also more likely to visit friends and relatives living in these high prevalence regions, and it is known that 65 per cent of people travelling to at risk countries do not get vaccinated against hepatitis B before they go.1

“Here in London, we have thousands of people born abroad who don’t realise they have the ticking time bomb of liver cancer inside them, because they haven’t been tested for hepatitis B”, commented Penny Webb, Coordinator of the Hepatitis B Foundation UK. “Yet despite the fact that we should be encouraging testing for these people and vaccination for their families, in practice we are putting them off by charging for these services in many cases. We are one of the few countries worldwide where this happens, and the situation urgently needs to change”.

The meeting also discussed other potential ways of educating London’s ethnic communities about hepatitis B, including: workshops in community centres; materials in schools and colleges/universities; an education programme for midwives; pharmacy-based campaigns; and a stand at cultural events such as the Notting Hill Carnival.

Numbers of preventable deaths from hepatitis B among London’s ethnic communities

At the 2001 census, 40% of London’s estimated population of 7.1 million were from ethnic communities (source: Commission for Racial Equality:www.cre.gov.uk/diveristy/map/london). This figure is thought to have increased substantially in recent years with the latest wave of immigration from East Europe. Among this estimated 2.84 million, the rate of chronic hepatitis B infection is around 2% (source: Prof G Foster; personal communication). Of those chronically infected, around half may eventually die of related liver complications unless effectively treated (source: Prof G Foster; personal communication).

About B Aware

The B Aware campaign was launched on October 2006, with the aim of making the Government aware of the growing disease burden of hepatitis B in the UK, and to promote the development of a national strategic action plan to prevent and manage the infection. This plan should include the following elements:

* Raising awareness of the impact caused by hepatitis B and what can be done to prevent, diagnose and treat it

* Improving surveillance to help track people infected chronically with hepatitis B, including those who have not been diagnosed

* Increasing screening and testing facilities

* Introducing routine immunisation for all babies and/or adolescents

* Improving access to support facilities, including innovative treatments; and training more specialist medical staff

The B Aware Campaign is conducted by the Association of Nurses in Substance Abuse, British Liver Trust, Children’s Liver Disease Foundation, Hepatitis B Foundation UK, Mainliners and sponsored by Bristol-Myers Squibb Pharmaceuticals Ltd.

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