Assessing the feasibility, acceptability and impacts of an education program on hepatitis B testing uptake among ethnic Chinese in Australia: results of a randomised controlled pilot study

Background In Australia, Chinese migrants are among the populations most affected by hepatitis B virus (HBV) infection but often experience late diagnosis or access to clinical care. This study aims to explore approaches to increase HBV testing in Australia’s Chinese community and inform evaluation planning, specifically to i) assess the feasibility and acceptability of HBV educational programs, and ii) compare HBV testing uptake in people receiving a tailored education resource focussing on liver cancer prevention compared with a standard HBV education package. Methods This is a pre-post mixed-methods pilot and feasibility study. People of Chinese ethnicity and unsure of their HBV infection or immunity status were recruited from ten community sites in Melbourne, Australia in 2019–2020. Participants were randomised to receive an education package (comprised of a leaflet and in-person one-on-one educational session) with a focus on either 1) standard HBV-related information, or 2) liver cancer prevention. Participants completed a baseline questionnaire prior to receiving the intervention and were followed up at 6 months’ time for a questionnaire and an opt-in semi-structured interview. Primary study outcomes included feasibility of study procedures, measured by recruitment, participation, and retention rates; acceptability of the education program assessed by acceptability scores; and HBV testing uptake rate in each arm. Secondary outcomes include HBV-related knowledge change, assessed by pre-post comparison; and factors affecting participants’ testing behaviour analysed using qualitative data. Results Fifty-four participants received an education package; baseline and follow-up data from 33 (61%) were available. The study procedures of recruitment and retention were feasible; the acceptability of the education program was moderate with improved HBV-related knowledge observed. Four participants self-reported being tested: one (1/15, 7%) in the standard HBV information group and three (3/18, 17%) in the liver cancer prevention information group. Factors identified as affecting testing included perceived relevance and seriousness of HBV, healthcare access and costs of testing, and perceptions of the role of primary care providers in HBV-related care. Conclusion A tailored education program targeting ethnic Chinese in Australia was feasible with moderate acceptability. A larger study is required to determine if a liver cancer prevention message would improve HBV testing uptake in Chinese community than standard HBV education message. Supports from healthcare providers, community-based testing programs, and public health education programs are likely needed to motivate diagnostic testing among Chinese people at risk of HBV infection.

Examining Liver Cancer Patients and a High-Risk Group in a Vulnerable Area: An Experience from the Ulleung Liver Cancer Prevention and Management Project

Ulleung county is a small island on the eastern side of the Korean peninsula. The Ulleung Liver Cancer Prevention and Management Project was launched in order to minimize newly developing liver cancer within this region. Population-based regional cancer registry data were analyzed to investigate the status and characteristics of registered liver cancer patients. The Interagency Workgroup of the project provided a special screening program from 1 November to 3 November 2018, and from 23 April to 25 April 2019, undertaking liver cancer screening and health behavior surveys. Logistic regression analysis was used to determine factors associated with recent liver cancer screening. In Ulleung county, hepatocellular carcinoma was identified as the main type of liver cancer, accompanied by a high incidence of hepatitis B. Approximately 25.0% of the participants were not aware of their liver condition. People who were aware of their liver condition and those who reported a general understanding of hepatitis B were more likely to have undergone recent liver cancer screening. To prevent the development and spread of the disease in the community, adequate infrastructure for cancer screening and an enhanced monitoring system are required, along with measures to create awareness to periodically determine liver condition in high-risk groups.

Anti-inflammatory and Antifibrotic Effects of Plant Regulatory Peptides in Patients with Steatohepatitis and Cirrhosis: Opportunities of Primary Liver Cancer Prevention

The pathogenesis of steatohepatitis, which develops on the background of non-alcoholic fatty liver disease and may be the cause of liver cirrhosis, is considered in the article. Also, the paper focuses on the prospects of using peptide drugs for the treatment of liver cirrhosis. The study found that the preparation of plant regulatory peptides GA-40 has pronounced hepatoprotective, anti-inflammatory and anti-fibrotic effects, which is confirmed by the elastometry data of the shear wave. The results of this work indicate that the use of the drug GA-40 was accompanied not only by the normalization of the inflammatory panel of the liver and triglycerides, but also by a likely decrease in the level of glypican-3 - the main factor that causes the development of primary liver cancer. Gene protector and immunocorrector GA-40, harmonizing metabolic processes in the liver, as well as suppressing inflammation and preventing excessive output of hepatocytes in apoptosis, has a positive effect on the prognosis of the disease. Reduced expression of glypican-3 in patients in the study group indicates that GA-40 is able to control the level of pro-oncogenic trigger proteins, thus reducing the risk of primary liver cancer.