Improving uptake of hepatitis testing in South East Asians

Hepatitis B (HBV) and C virus (HCV) cause infection in the liver and if not diagnosed and treated result in life threating liver scarring (cirrhosis), liver cancer and end stage liver disease (ESLD).

Previously, HBV & HCV have been perceived as incurable. Advances in the available and emerging therapies mean HCV infection is potentially curable and HBV treatable. However, HBV & HCV is rising disproportionately, with ethnic minorities having 7-10 times more HCV related end stage liver disease (ESLD) and 16-35 times more hepatocellular carcinoma, than Caucasians.

The experience, at Frimley Park Hospital, shows a that large number of first generation South East Asian (SEA) patients present to our Liver Unit with already advanced,untreated liver disease. This group typically, have not previously engaged with their GP or other health services. This is due to the disease being asymptomatic, hence not diagnosed until presentation with cirrhosis. Through earlier pilot work we also realise a lack of engagement by the SEA population is due to cultural, language and educational barriers to disease awareness, testing and treatment. As set out by NICE, to prevent further death and disease spread we need to find new ways of informing and testing this ‘hard to reach’ group.

The aim of this project is to use culturally sensitive local knowledge to address these barriers so together we can increase the awareness and the importance of undertaking hepatitis testing and treatment. We will firstly develop an educational intervention (a video) that informs this population and secondly, conduct hepatitis testing in a non-health setting more familiar to patients, as recommended by NICE(mosques/community health centres). Once developed, we will conduct a feasibility study to assess the recruitment potential of this new intervention at different sites prior to conducting a clinical trial to test its effectiveness (beyond the scope of this study).