Foundation’s study of the connection between hepatitis B and metabolic syndrome to ‘save a lot of lives’

This month the Hepatitis Foundation of New Zealand is commencing an exciting and unique study of how metabolic syndrome in people with hepatitis B may make them more prone to liver cancer.

The Hepatitis B virus leads to inflammation of the liver and is spread through blood-to-blood contact and bodily fluids. Metabolic syndrome is a term for a cluster of medical conditions including obesity, diabetes and high cholesterol.

The Liver Research Project will be led by Auckland-based Dr Papu Prasad.

Dr Prasad says there is a need in hepatitis B research community to put metabolic syndrome ” under the lens. “I think the presence of metabolic syndrome in people living with hepatitis B makes them prone to liver cancer. With this study, we can find out the relations between these two conditions and decide when we should be screening these people for liver cancer. This will definitely save a lot of lives with early diagnosis as cure available for early stage cancer.”

He says the project will hopefully bring about earlier diagnosis and treatment rates of liver cancer in people living with metabolic syndrome and hepatitis B.

Professor Ed Gane.

Dr Prasad is an MD candidate at the University of Auckland under Professor Ed Gane, an internationally recognised liver expert and trustee at the Foundation. He says much of the preparation for this research was completed with the New Zealand Liver Transplant Unit (NZLTU) last year.

Dr Prasad says the Liver Research Project is unique because metabolic syndrome and hepatitis B have never been studied in a community setting. “The studies done on this subject in the past have all been done in a hospital set up, where you see much sicker people, people who have been selected because of their illness. There is a lot of bias in these studies.”

He says the Liver Research Project is also special because of the longitudinal health data available in community settings. “The Foundation has been following up people with hepatitis B since the early 80s.This is a very long-term follow-up in a community setting.”

Susan Hay, Chief Executive of the Hepatitis Foundation of New Zealand, says the Foundation is delighted to lead a project which has the potential help to save lives. “Viral hepatitis is the leading cause of liver cancer worldwide so it’s extremely important to find ways to improve patient health outcomes. We believe this study will provide a better understanding of how we can effectively manage liver cancer in the hepatitis B community.”

Dr Prasad says he is very excited about the collaboration with the Hepatitis Foundation. “The Foundation plays a huge role in the management of hepatitis B in this country. We are very lucky to have the Foundation looking after people living with viral hepatitis in New Zealand,” he says. Around 100,000 people live with chronic hepatitis B in New Zealand.

The Kawerau Study – Paving the management of hepatitis B in New Zealand in the 1980s

The data from blood samples being restudied for the Liver Research Project was gathered by the Foundation in the 1980s for a study which helped reveal the prevalence of hepatitis B in New Zealand. In 1984, the newly established Hepatitis Foundation of New Zealand implemented the Kawerau Seroprevalence Study. The Foundation tested 93 per cent of Kawerau’s population for hepatitis B. The results showed that the hepatitis B virus was highly endemic.

The Kawerau Seroprevalence Study influenced the introduction of a universal hepatitis B vaccination in for all children in New Zealand in 1987. New Zealand was the first country to do this. From 1999 to 2002 the Foundation also then went on to conduct the largest ever national hepatitis B screening programme ever in New Zealand. A total of 177,292 New Zealanders were screened with 11,936 people with chronic hepatitis B identified. Today, the Foundation monitors more than 25,000 people living with chronic hepatitis B.

Facts:
  • Hepatitis B is spread through blood-to-blood contact and leads to inflammation of the liver
  • Viral hepatitis is the leading cause of liver cancer worldwide
  • Around 100,000 people in New Zealand live with chronic hepatitis B. Many of those people are undiagnosed because symptoms often don’t appear for decades
  • An estimated 257 million people worldwide are living with hepatitis B virus infection
  • In 2015, hepatitis B resulted in 887 000 deaths. Most deaths occurred from complications (including cirrhosis (liver scarring) and hepatocellular carcinoma (a type of liver cancer)).
Hepatitis B risk factors:

Those most at risk of hepatitis B are people who:

  • Are of Māori, Pacific Island, or Asian ethnicity over the age of 25 years
  • Were born outside New Zealand
  • Have a mother or close family member has hepatitis B
  • Live with someone who has hepatitis B
  • Have ever had unprotected sexual contact with an HBV person
  • Ever injected drugs (once is enough)
  • Have received a tattoo using unsterile equipment.

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