title: Targeted case finding for hepatitis B using dry blood spot testing in the British-Chinese and South Asian populations of the North-East of England.
abstract: Chronic infection with the hepatitis B virus (HBV) is a frequent cause of cirrhosis and liver cancer. Targeted HBV screening is recommended by the Centre for Disease Control (CDC) and Prevention for subjects born in countries with >2% HBV prevalence. However, there are no UK guidelines. Here, we applied the (CDC) recommendations to the British-Chinese and British-South Asian community of North-East (NE) England. British-Chinese and South Asian subjects were invited to attend for HBV education and screening sessions held in community centres. Hepatitis B surface antigen (HBsAg) and hepatitis B core total antibody (HBcAb) were tested with dry blood spot tests. South Asians were also tested for hepatitis C antibody (HCVAb). A total of 1126 subjects (606 Chinese and 520 South Asian) were screened. Sixty-two (5.5%) were HBsAg positive. Ten of these reported a previous diagnosis of HBV. The prevalence of HBsAg positivity was 4.6% when previously diagnosed individuals were excluded. The HBsAg prevalence was significantly higher in the Chinese subjects compared with South Asians (8.7% VS. 1.7% P < 0.001). In Chinese subjects, HBsAg positivity was highest in subjects born in Vietnam (17.4%), followed by China (11%), Hong Kong (7.8%) and the UK (6.7%). Subjects from Pakistan had the highest HBsAg and HCV Ab prevalence in the South Asians (3.1% and 1.8%, respectively). Ten percentage of HBsAg positive patients who had follow-up assessment had active disease requiring antiviral treatment. Undiagnosed HBV infection was above the 2% threshold for screening suggested by the CDC in the British-Chinese and Pakistani community of NE England, which provides evidence for a UK HBV-targeted screening programme.
authors.affiliation: Liver Unit, Freeman Hospital, Newcastle upon Tyne Hospitals Foundation NHS Trust, Newcastle upon Tyne, UK. stuart.mcpherson@nuth.nhs.uk
authors.forename: S
authors.initials: S
authors.lastname: McPherson
authors.forename: M
authors.initials: M
authors.lastname: Valappil
authors.forename: S E
authors.initials: SE
authors.lastname: Moses
authors.forename: G
authors.initials: G
authors.lastname: Eltringham
authors.forename: C
authors.initials: C
authors.lastname: Miller
authors.forename: K
authors.initials: K
authors.lastname: Baxter
authors.forename: A
authors.initials: A
authors.lastname: Chan
authors.forename: K
authors.initials: K
authors.lastname: Shafiq
authors.forename: A
authors.initials: A
authors.lastname: Saeed
authors.forename: R
authors.initials: R
authors.lastname: Qureshi
authors.forename: M
authors.initials: M
authors.lastname: Hudson
authors.forename: M F
authors.initials: MF
authors.lastname: Bassendine
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001769:Blood / Q000276:immunology* / Q000821:virology*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003890:Desiccation / Q000379:methods*; D004739:England / Q000453:epidemiology; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013048:Specimen Handling / Q000379:methods*; D014773:Virology / Q000379:methods
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies
keywords: case finding; dry blood spot testing; hepatitis B; hepatitis C; screening