Hepatitis B is a virus that is replicated in the liver and causes hepatic dysfunction. The degree of infection is a state of dynamic interaction between the viral replication cycle and the host immune response. This acute or chronic status of hepatitis B is usually a lifelong infection leading to cirrhosis, HBV associated glomerulonephritis and hepatocellular carcinoma.

Hepatitis B infection is endemic in Aboriginal and Torres Strait Islander (TSI) people in remote communities in Far North Queensland. Effective prevention strategies have only started to be implemented in the past few decades. The remoteness, social structure and traditional activities of these people, plus the way in which these cultures view health, all impact on our health service delivery.

Aboriginal and TSI people also have very high rates of ESRD requiring renal replacement therapy. The purpose of our study was to define the prevalence of HBV infection in the renal dialysis unit in Cairns, and implement a coordinated algorithm based HBV immunisation programme, while working with primary health care providers.

Results:
100% dialysis patients tested and immunised.
Tracking method and data collection captured 100% targeted population.

Evaluation:
Worthwhile exercise for dialysis patients due to relatively high conversion rate.

Requires identified staff or system for longevity of programme.
Implementation of CKD patients initiated.

The clinical outcomes demonstate the challenges in maintaining up-to-date client records in culturally diverse and geographically dispersed populations. Renal patients are immuno-compromised, therefore, renal staff are committed to safeguarding their health status as Protection from Hepatitis B is Paramount.