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Background: Mother-to-child transmission (MTCT) of hepatitis B can be prevented with targeted interventions; however, MTCT continues to occur in Australia and globally. This qualitative research investigated how mothers with chronic hepatitis B (CHB) understand and experience interventions for the prevention of MTCT of CHB (PMTCT-CHB) in Victoria, Australia. Methods: Semi-structured interviews were conducted with women with CHB. Participants were recruited through purposive and snowballing sampling. Interviews explored the women's experience of care for themselves and their infants aimed at PMTCT-CHB. Interviews were conducted over the phone with a qualified interpreter where required. The consolidated criteria for reporting qualitative research framework was used with data thematically analysed. This study was co-designed with mothers with CHB through a Community Advisory Group established for this research; coordinated and supported by LiverWELL and the researchers. Results: Sixteen women were interviewed. Although most women understood the purpose of hepatitis B vaccination, there were significant gaps in information and education provided to mothers regarding PMTCT-CHB. These gaps included understanding of the extent of protection of vaccination, breastfeeding with CHB, post-vaccination testing for infants and lack of clarity of the woman's own hepatitis B status. There was notable fear and worry associated with hepatitis B transmission, with emotional support for mothers identified as a major gap in service delivery. Additionally, some women experienced stigma and discrimination due to their hepatitis B and refugee status. Conclusions: This study explored how mothers with CHB understand and experience interventions to prevent MTCT. Our findings reveal substantial gaps in delivery of information and care in the context of PMTCT-CHB in Victoria. Our findings can support development of evidence-based interventions and systems to improve healthcare for mothers with CHB and their infants, and thereby reduce possible CHB transmission and other negative outcomes, including stigma and discrimination. This research investigated how mothers with chronic hepatitis B understand and experience interventions for the prevention of mother-to-child transmission of chronic hepatitis B in Victoria, Australia. It provides knowledge and insights in healthcare delivery gaps for pregnant women with hepatitis B and their infants. [ABSTRACT FROM AUTHOR]

Background A higher prevalence of chronic hepatitis B (CHB) has been reported in Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal Australians. An Australian infant and adolescent hepatitis B virus (HBV) vaccination program was implemented in 2000. Meta-analysis methods will be used to examine if the pooled prevalence of CHB decreased after 2000 among Aboriginal Australians.Methods: Embase, Medline and Web of Science were searched from 1 January 1981 to 29 March 2018 and all issues of the Northern Territory and New South Wales Public Health Bulletins. Studies needed to report the number of individuals who were tested and tested positive for hepatitis B surface antigen (HBsAg).Results: There were 36 studies; 16 before and 20 after 2000; reporting 84 prevalence estimates. Population groups included: adults (14 studies), pregnant women (13 studies), prisoners (five studies) children or teenagers (10 studies) and infants (two studies). The pooled prevalence of HBsAg decreased overall (from 10.8% before 2000 vs 3.5% after 2000), in women (4.2% vs 2.2%), in males (17.5% vs 3.5%), in regional (7.8% vs 3.9%) and remote (14.4% vs 5.7%) areas, in New South Wales (12.3% vs 3.0%), in the Northern Territory (6.1% vs 5.1%), in adults (15.3% vs 4.3%) and in pregnant women (3.6% vs 2.6%).Conclusion: The prevalence of HBsAg decreased among Aboriginal people after 2000. [ABSTRACT FROM AUTHOR]

African-Australians have a high prevalence of chronic hepatitis B (CHB) and an increased risk of liver cancer (hepatocellular carcinoma, HCC) at a younger age than other affected groups living with CHB. The prevention of HCC-related mortality is possible with timely diagnosis of CHB, regular monitoring including liver cancer surveillance and appropriate treatment with antiviral therapy. Currently, little is known about how African-Australians living with CHB understand their condition, their risk of liver cancer and the need for regular monitoring. There were 19 semi-structured interviews conducted with African-Australians who have CHB. The interviews explored the participants' knowledge of CHB, their perceptions of future health risks and experiences and understanding of healthcare. The three major themes identified in the analysis were (i) the risks to physical health including liver cancer, (ii) risks to social and emotional wellbeing from diagnosis and disclosure and (iii) the fear and worry associated with being infectious. The understanding of risk and mitigation of that risk was framed by their understanding of health, ageing, as well as participants' educational background and faith. Our findings show the importance of engagement with the broader social and emotional effects of CHB by clinicians and services, and can assist in developing interventions to increase participation in healthcare, including liver cancer surveillance. [ABSTRACT FROM AUTHOR]