LCQ14: Prevention and treatment of hepatitis

LCQ14: Prevention and treatment of hepatitis 
Question:
 
     It is learnt that hepatitis is one of the common diseases in Hong Kong, and it is estimated that hundreds of thousands of people in Hong Kong are affected by hepatitis. Hepatitis may further develop into cirrhosis of the liver or even liver cancer if it is not diagnosed and treated in a timely manner, which will bring about a serious impact on the health and finances of patients and their families, and place a burden on the public healthcare system. In this connection, will the Government inform this Council:
 
(1) in respect of education on the prevention of hepatitis, whether the Government has organised preventive educational programmes to promote the importance of keeping the liver healthy in schools and in the community in 2024; if so, of the relevant expenditure, the number of programmes organised, as well as the respective numbers of students or members of the community who have participated in such programmes; whether it will increase the relevant estimated expenditure for this year; if it will, of the details; if not, the reasons for that;
 
(2) in view of the Government’s commitment in the 2024 Policy Address to implement hepatitis B screening to prevent liver cancer, whether the Government has formulated the relevant implementation plan; if it has, of the budget and target number of people to be screened; whether it will accord priority to screening for high-risk persons, and introduce primary healthcare networks and the public-private partnership approach to expand the screening capacity, e.g. carrying out blood monitoring for liver cancer in high-risk groups; if it will, of the details; if not, the reasons for that;
 
(3) whether it knows the respective numbers of new cases of liver cirrhosis diagnosed by the Hospital Authority (HA) and patients with liver cirrhosis who continued to receive treatment in public hospitals under HA in each of the past five years;
 
(4) whether it knows the respective numbers of cases of liver cirrhosis and liver cancer among the oesophago-gastro-duodenoscopy services provided in public hospitals in each of the past five years; whether the relevant data reflects the incidence trends of liver cirrhosis and liver cancer in Hong Kong; whether the Government has adjusted its prevention strategies on the basis of such data; and
 
(5) in order to provide more treatment options for patients and effectively relieve the pressure on public hospitals, whether the Government will consider using the public-private partnership approach or expanding the scope of the “Elderly Health Care Voucher Greater Bay Area Pilot Scheme” to arrange, under the risk-based principle, for low-risk patients to receive treatment at healthcare institutions in the Mainland cities of the Guangdong-Hong Kong-Macao Greater Bay Area; if so, of the details; if not, the reasons for that?

Reply:
 
President,
 
     Hepatitis is an inflammation of the liver, which can be classified into acute or chronic disease. Serious hepatitis cases will lead to liver failure, cirrhosis or liver cancer Hepatitis is the most commonly caused by the hepatitis virus infection worldwide. In Hong Kong, the major risk factor leading to liver diseases including liver cancer is chronic hepatitis B (CHB) infection. The Government is strongly committed to the prevention and treatment of hepatitis and liver cancer. Among which, in 2018, the Government established the Steering Committee on Prevention and Control of Viral Hepatitis (SCVH) to provide advice on overall policy, targeted strategies and effective resource allocation related to prevention and control of viral hepatitis. In October 2020, the SCVH formulated the Hong Kong Viral Hepatitis Action Plan 2020 – 2024 and all the new initiatives outlined in the plan have been fully implemented.
 
     The Government has been adopting a series of effective and free-of-charge measures to prevent mother-to-child transmission (MTCT) of hepatitis B virus (HBV) which may lead to CHB, including:
 
(i) universal neonatal hepatitis B vaccination since 1988;
(ii) universal antenatal screening for hepatitis B;
(iii) administration of hepatitis B immunoglobulin for babies born to mothers with hepatitis B;
(iv) using antivirals to further minimise the risk of MTCT of HBV among pregnant women with CHB and high viral load since August 2020 under the steer of the SCVH; and
(v) post-vaccination serologic testing arranged for babies born to mothers with hepatitis B since January 2022. 
     The reply, in consultation with the DH, the Primary Healthcare Commission (PHC Commission) and the Hospital Authority (HA) to the question raised by the Hon Joephy Chan is as follows:
 
(1) Viral Hepatitis Control Office (VHCO) of the DH co-ordinates the actions and programmes related to prevention and control of viral hepatitis, including health education, and surveillance and prevention of viral hepatitis, and provides secretariat support to the SCVH. The VHCO has been providing health education related to viral hepatitis for the public through various channels, including social media, health talks and themed exhibitions. The VHCO also collaborates with community partners to launch promotion activities. 
 
     Currently, the Maternal and Child Health Centres under the DH provide hepatitis B vaccination services for infants and young children from birth to five years old. For those primary school children who have not completed the hepatitis B vaccination, the School Immunisation Team under the Centre for Health Protection of the DH provides mop-up vaccination services to ensure that local school children are protected by the hepatitis B vaccine. The current vaccination rate for school children is 99 per cent while the prevalence of HBV infection among those under 35 years old is below 1 per cent. Hence, the health promotion efforts of the VHCO focus on reminding adults at higher risk of infection in the community to undergo early testing and treatment for hepatitis B, including those who have not been benefited from vaccination.
 
     In 2024, the VHCO conducted nine public health talks and 11 themed exhibitions, reaching over 7 000 attendances. Over 33 000 health education materials were distributed to community health promotion partners, healthcare institutions and the general public. The related expenditure cannot be separately identified given that they have been subsumed into the viral hepatitis control programmes provided by the DH.
 
     The Government will closely keep in view local and international situation of hepatitis B, promulgate the Hong Kong Viral Hepatitis Action Plan 2025 – 2030 this year, and continue to enhance health promotion and educational activities.
 
     Meanwhile, District Health Centres and District Health Centres Expresses (collectively referred to as DHCs) in all 18 districts across the city are promoting the Life Course Preventive Care Plan along with family doctors to enhance citizens’ self-management ability. Family doctors and primary healthcare professionals will provide vaccination information and education (such as Hepatitis B vaccine), guidance on healthy lifestyles, as well as recommendations and services for chronic disease and cancer screening, according to personal factors like age, sex and family history. DHCs also organise talks on liver health, providing the public with related education and information.
 
(2) The DH has been enhancing the focused risk-based testing service for viral hepatitis for people at a higher risk of HBV infection in its Services in recent years. With effect from April 2022, all men who have sex with men and sex workers attending Social Hygiene Clinics of the DH are offered with HBV screening as part of the comprehensive screening for sexually transmitted infections. With effect from July 2023, the DH has launched risk-based viral hepatitis screening services at its Elderly Health Service, Woman Health Service, Families Clinics and methadone clinics.
 
     As announced in the 2024 Policy Address, the Government will roll out a new programme to subsidise hepatitis B screening to prevent liver cancer. The PHC Commission will provide hepatitis B screening and continued management to groups with higher risk via DHCs and family doctors through strategic purchasing and co-payment model. The programme enables early detection of people infected with HBV in the community and early identification and treatment of CHB to reduce the risk of complications (such as cirrhosis and liver cancer). The PHC Commission will announce the programme details within 2025.
 
(3) The number of in-patient and day-in-patient discharges and deaths with the principal diagnosis of chronic liver disease and liver cirrhosis at various hospitals under the HA in the past five years is set out as follows: