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Peer-reviewedCC BYJournal of viral hepatitis

Anti-Viral Treatment Eligibility and Treatment Uptake Among People With Chronic Hepatitis B in Australia: The REACH-B Study.

  • Behzad Hajarizadeh1
  • Renjy Nelson2
  • Jacob George3
  • Josh Hanson1,4
  • Jane Davies5
  • Marianne Martinello1,6
  • Tracey Brown6
  • Ian Wong7
  • Tasnim Hasan7
  • Lester Mascarenhas8
  • James O'Beirne9
  • Amanda Wade10
17 more authors
  • Marilou Capati11
  • Georgina Trotter12
  • Sarah Thomas12
  • Lloyd Nash12
  • Benjamin Cowie13,14
  • Nicole Allard14,15
  • Thomas Tu3,16
  • Lien Tran13,14,16
  • Stephanie Howard12
  • Robert Monaghan1
  • Jessica Carter1
  • Elise Tu1
  • Amanda Erratt1
  • Joanne Carson1
  • Gregory J Dore1,17
  • Gail V Matthews1,17
  • REACH‐B Study Group
17 affiliations
  1. 1The Kirby Institute, University of New South Wales (UNSW), Sydney, New South Wales, Australia.
  2. 2The Queen Elizabeth Hospital and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  3. 3Storr Liver Centre, Westmead Hospital, and The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia.
  4. 4Cairns and Hinterland Hospital and Health Service, and Torres and Cape Hospital and Health Service, Cairns, Queensland, Australia.
  5. 5Menzies School of Health Research, Darwin, Northern Territory, Australia.
  6. 6Justice Health and Forensic Mental Health Network NSW, Sydney, New South Wales, Australia.
  7. 7Blacktown Mt Druitt Hospital, Sydney, New South Wales, Australia.
  8. 8Utopia Refugee and Asylum Seeker Health, Melbourne, Victoria, Australia.
  9. 9Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia.
  10. 10Barwon Health, Geelong, Victoria, Australia.
  11. 11Top End Medical Centre, Darwin, Northern Territory, Australia.
  12. 12Western Australia Country Health Service, Perth, Western Australia, Australia.
  13. 13Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  14. 14WHO Collaborating Centre for Viral Hepatitis, and the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
  15. 15Cohealth, Melbourne, Victoria, Australia.
  16. 16Hepatitis B Voices Australia, Melbourne, Victoria, Australia.
  17. 17St Vincent's Hospital, Sydney, New South Wales, Australia.
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Abstract

Treatment indication for chronic hepatitis B (CHB) varies across clinical guidelines. This study evaluated treatment eligibility and uptake in a large Australian cohort of people with CHB. The REACH-B study recruited people with CHB managed through a national network of healthcare services. Participants were categorised into three groups: (1) receiving antiviral therapy; (2) untreated despite eligibility; (3) untreated and ineligible. Treatment eligibility was determined using Australian Pharmaceutical Benefits Scheme (PBS) criteria, and by international clinical guidelines. Among 3648 participants (56% male; median age 48 years; 49% born in North-East or South-East Asia; 27% First Nations Australians), 14% were HBeAg positive and 7% had cirrhosis. Overall, 47% (n = 1666) were on antiviral therapy, 45% (n = 1573) were untreated and ineligible and 7% (n = 251) were untreated despite eligibility based on Australian PBS criteria. In adjusted analysis, the likelihood of remaining untreated despite eligibility was higher among women (aOR 1.59, 95% CI 1.34, 1.88) and younger participants (age 41-60 vs. > 60 years: aOR 1.51, 95% CI 1.01-2.28; ≤ 40 vs. > 60 years: aOR 2.65, 95% CI 1.60, 4.40). The proportion untreated despite eligibility increased to 13% when applying 2024 World Health Organisation guidelines and ranged 2%-44% based on other guidelines, highlighting the variability across the guidelines. In conclusion, among REACH-B participants, most eligible individuals receive treatment. Lower treatment uptake among women and younger people despite eligibility partly reflects lower threshold for elevated ALT in women, and clinician determination of non-CHB related ALT elevation. As treatment guidelines evolve and eligibility criteria broaden, monitoring treatment patterns is important.

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Cite

BibTeXRIS
BibTeX
@article{hajarizadeh2026antiviral,
  title = {{Anti-Viral Treatment Eligibility and Treatment Uptake Among People With Chronic Hepatitis B in Australia: The REACH-B Study.}},
  author = {Behzad Hajarizadeh and Renjy Nelson and Jacob George and Josh Hanson and Jane Davies and Marianne Martinello and Tracey Brown and Ian Wong and Tasnim Hasan and Lester Mascarenhas and James O'Beirne and Amanda Wade and Marilou Capati and Georgina Trotter and Sarah Thomas and Lloyd Nash and Benjamin Cowie and Nicole Allard and Thomas Tu and Lien Tran and Stephanie Howard and Robert Monaghan and Jessica Carter and Elise Tu and Amanda Erratt and Joanne Carson and Gregory J Dore and Gail V Matthews and REACH‐B Study Group},
  journal = {Journal of viral hepatitis},
  year = {2026},
  month = nov,
  doi = {10.1111/jvh.70238},
  url = {https://europepmc.org/article/MED/42969469},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Anti-Viral Treatment Eligibility and Treatment Uptake Among People With Chronic Hepatitis B in Australia: The REACH-B Study.
AU  - Behzad Hajarizadeh
AU  - Renjy Nelson
AU  - Jacob George
AU  - Josh Hanson
AU  - Jane Davies
AU  - Marianne Martinello
AU  - Tracey Brown
AU  - Ian Wong
AU  - Tasnim Hasan
AU  - Lester Mascarenhas
AU  - James O'Beirne
AU  - Amanda Wade
AU  - Marilou Capati
AU  - Georgina Trotter
AU  - Sarah Thomas
AU  - Lloyd Nash
AU  - Benjamin Cowie
AU  - Nicole Allard
AU  - Thomas Tu
AU  - Lien Tran
AU  - Stephanie Howard
AU  - Robert Monaghan
AU  - Jessica Carter
AU  - Elise Tu
AU  - Amanda Erratt
AU  - Joanne Carson
AU  - Gregory J Dore
AU  - Gail V Matthews
AU  - REACH‐B Study Group
PY  - 2026
DA  - 2026/11/02
JO  - Journal of viral hepatitis
DO  - 10.1111/jvh.70238
UR  - https://europepmc.org/article/MED/42969469
AB  - Treatment indication for chronic hepatitis B (CHB) varies across clinical guidelines. This study evaluated treatment eligibility and uptake in a large Australian cohort of people with CHB. The REACH-B study recruited people with CHB managed through a national network of healthcare services. Participants were categorised into three groups: (1) receiving antiviral therapy; (2) untreated despite eligibility; (3) untreated and ineligible. Treatment eligibility was determined using Australian Pharmaceutical Benefits Scheme (PBS) criteria, and by international clinical guidelines. Among 3648 participants (56% male; median age 48 years; 49% born in North-East or South-East Asia; 27% First Nations Australians), 14% were HBeAg positive and 7% had cirrhosis. Overall, 47% (n = 1666) were on antiviral therapy, 45% (n = 1573) were untreated and ineligible and 7% (n = 251) were untreated despite eligibility based on Australian PBS criteria. In adjusted analysis, the likelihood of remaining untreated despite eligibility was higher among women (aOR 1.59, 95% CI 1.34, 1.88) and younger participants (age 41-60 vs. > 60 years: aOR 1.51, 95% CI 1.01-2.28; ≤ 40 vs. > 60 years: aOR 2.65, 95% CI 1.60, 4.40). The proportion untreated despite eligibility increased to 13% when applying 2024 World Health Organisation guidelines and ranged 2%-44% based on other guidelines, highlighting the variability across the guidelines. In conclusion, among REACH-B participants, most eligible individuals receive treatment. Lower treatment uptake among women and younger people despite eligibility partly reflects lower threshold for elevated ALT in women, and clinician determination of non-CHB related ALT elevation. As treatment guidelines evolve and eligibility criteria broaden, monitoring treatment patterns is important.
SN  - 1352-0504
SN  - 1365-2893
ER  -