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Public health management of hepatitis B virus contacts

To the Editor: The Auckland Statement on Viral Hepatitis, released in September 2012, called for action to prevent new hepatitis B and C infections.1 Estimates suggest that more than 200 000 Australians are living with chronic hepatitis B virus (HBV) infection, with nearly half being unaware of their diagnosis.2,3 Childhood vaccination is crucial to HBV prevention, but many people from high-risk populations, including immigrants and refugees from endemic countries, are infected before arriving in Australia.4 Targeted screening of high-risk groups for susceptibility or undiagnosed infection is therefore also integral to public health management of HBV infection.

Although susceptible household contacts and sexual partners of all patients with HBV infection are at risk, most jurisdictions only follow up contacts for notifications of acute HBV infection and not unspecified or chronic infections, which represent over 95% of notifications.5 Contact testing therefore relies on local doctors, but contacts often do not attend the same clinic as the index patient, and incomplete contact follow-up is inevitable.…