The diversity and management of chronic hepatitis B virus infections in the United Kingdom: a wake-up call

Tedder, R.S. et al. (2013) The diversity and management of chronic hepatitis B virus infections in the United Kingdom: a wake-up call. Clinical Infectious Diseases, 56(7), pp. 951-960. (doi: 10.1093/cid/cis1013)

Abstract

<p>Background. Through migration, diversity of chronic hepatitis B virus (HBV) infection has changed, affecting disease burden and control. We describe clinical and viral characteristics of chronic HBV in the United Kingdom.</p> <p>Methods. A total of 698 individuals with chronic HBV infection were recruited from referral liver centers. Demographic, clinical, and laboratory data were collected.</p> <p>Results. Sixty-one percent of patients were male, 80% were not born in the United Kingdom, and the largest ethnicity was East/Southeast Asian (36%). Twenty-two percent were hepatitis B e antigen (HBeAg) seropositive; 20.4% (59/289) had cirrhosis and 10 (1.7%) had hepatocellular carcinoma. Genotype D was most common (31%) followed by A, C, B, and E (20%, 20%, 19%, and 9%, respectively). Genotype was significantly associated with country of birth, length of time in the United Kingdom, HBeAg status, and precore and basal core promoter mutations. One-third were on treatment, with men independently more likely to be treated. Only 18% of those on treatment were on recommended first-line therapies, and 30% were on lamivudine monotherapy. Among treated individuals, 27% had antiviral drug resistance. Testing rates for human immunodeficiency virus, hepatitis C virus, and delta coinfections were low.</p> <p>Conclusions. We demonstrated diversity of chronic HBV infections in UK patients, suggesting that optimal management requires awareness of the variable patterns of chronic HBV in countries of origin. We also found less-than-optimal clinical management practices, possible gender-based treatment bias, and the need to improve testing for coinfections.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mills, Professor Peter
• Authors: Tedder, R.S., Rodger, A.J., Fries, L., Ijaz, S., Thursz, M., Rosenberg, W., Naoumov, N., Banatvala, J., Williams, R., Dusheiko, G., Chokshi, S., Wong, T., Rosenberg, G., Moreea, S., Bassendine, M., Jacobs, M., Mills, P.R., Mutimer, D., Ryder, S.D., Bathgate, A., Hussaini, H., Dillon, J.F., Wright, M., Bird, G., Collier, J., Anderson, M., and Johnson, A.M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Infectious Diseases
• ISSN: 1058-4838
• ISSN (Online): 1537-6591
• Published Online: 07 December 2012