title: The changing face of hepatitis B in greater Glasgow: epidemiological trends 1993-2007.
abstract: OBJECTIVE
  Whilst hepatitis B (HBV) is historically uncommon in Scotland, anecdotal experience suggests an increasing prevalence of chronic infection. We sought to establish whether the incidence of chronic HBV is increasing in Greater Glasgow, and whether patients are assessed in secondary care.
  
  
  METHODS
  The regional virus centre database identified HBV surface antigen (HBsAg) positive samples. For adult patients tested in Glasgow between 1993-2007 the first positive test was identified and classified as acute or chronic infection serologically. Clinic referral and attendance data was then obtained.
  
  
  RESULTS
  1,672 patients tested HBsAg positive; 1051 with chronic infection, 421 acute and 200 indeterminate. New diagnoses of HBV remained stable over time, however falling numbers of acute cases were mirrored by a rise in chronic cases from 40 to 119 per annum between 2000 and 2007. Of 193 patients diagnosed in 2006 and 2007, 51% were not seen in secondary care due to non referral (43%) or non attendance (8%).
  
  
  CONCLUSIONS
  Chronic HBV trebled in Glasgow between 2000 and 2007. Most patients were not assessed in secondary care. Improved levels of clinic referral and attendance are required to ensure best care for HBV patients in Glasgow.
authors.affiliation: Department of Gastroenterology, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK. Stephen.barclay@ggc.scot.nhs.uk
authors.forename: S T
authors.initials: ST
authors.lastname: Barclay
authors.forename: S
authors.initials: S
authors.lastname: Cameron
authors.forename: P R
authors.initials: PR
authors.lastname: Mills
authors.forename: M
authors.initials: M
authors.lastname: Priest
authors.forename: F
authors.initials: F
authors.lastname: Ross
authors.forename: R
authors.initials: R
authors.lastname: Fox
authors.forename: C
authors.initials: C
authors.lastname: Goulding
authors.forename: E H
authors.initials: EH
authors.lastname: Forrest
authors.forename: A J
authors.initials: AJ
authors.lastname: Morris
authors.forename: M
authors.initials: M
authors.lastname: Neilson
authors.forename: A J
authors.initials: AJ
authors.lastname: Stanley
mesh_terms: D000208:Acute Disease; D006509:Hepatitis B / Q000453:epidemiology*; D019694:Hepatitis B, Chronic / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D012606:Scotland / Q000453:epidemiology