title: Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands.
abstract: In low-endemic countries it is debated whether first-generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first-generation Chinese migrants.
  
  
  
  Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first-generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: (i) antiviral therapy, (ii) strict follow-up because of high hepatitis B DNA levels and/or (iii) surveillance for hepatocellular carcinoma.
  
  
  
  In total, 4423 persons participated in the projects of whom 6.0% (n = 264) were HBsAg positive. One hundred and twenty-nine newly diagnosed HBsAg-positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%).
  
  
  
  In our screening project in first-generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three of four analysed HBsAg-positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care.
authors.affiliation: Department of Gastroenterology and Hepatology, Rijnstate Hospital Arnhem, Arnhem, the Netherlands. sandracoenen80@yahoo.com.
authors.forename: Sandra
authors.initials: S
authors.lastname: Coenen
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: van Meer
authors.affiliation: Department of Gastroenterology and Hepatology, Rijnstate Hospital Arnhem, Arnhem, the Netherlands.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Vrolijk
authors.affiliation: Department of Internal Medicine and Infectious diseases, Rijnstate Hospital Arnhem, Arnhem, the Netherlands.
authors.forename: Clemens
authors.initials: C
authors.lastname: Richter
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Karel J
authors.initials: KJ
authors.lastname: van Erpecum
authors.affiliation: Department of Infectious Disease Control, Municipal Health Services, Rotterdam, the Netherlands.
authors.forename: Marijke C
authors.initials: MC
authors.lastname: Mostert
authors.affiliation: Department of Infectious Disease Control, Municipal Health Services, Rotterdam, the Netherlands.
authors.forename: Irene K
authors.initials: IK
authors.lastname: Veldhuijzen
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Jurriën G P
authors.initials: JG
authors.lastname: Reijnders
authors.affiliation: Department of Gastroenterology and Hepatology, Medical Center Haaglanden The Hague, The Hague, the Netherlands.
authors.forename: Hanneke
authors.initials: H
authors.lastname: van Soest
authors.affiliation: Department of Infectious Disease Control, Municipal Health Services, The Hague, the Netherlands.
authors.forename: Kees
authors.initials: K
authors.lastname: Dirksen
authors.affiliation: Department of Gastroenterology and Hepatology, Radboudumc Nijmegen, Nijmegen, the Netherlands.
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
authors.affiliation: Department of Infectious Disease Control, Municipal Health Services, Gelderland Zuid, the Netherlands.
authors.forename: René P M
authors.initials: RP
authors.lastname: Koene
authors.affiliation: Department of Infectious Disease Control, Municipal Health Services, Gelderland Midden, the Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: Bosschart
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Friederich
authors.affiliation: Department of Gastroenterology and Hepatology, Maxima Medical Center Eindhoven, Eindhoven, the Netherlands.
authors.forename: Martijn J
authors.initials: MJ
authors.lastname: Ter Borg
authors.affiliation: Departments of Infectious Disease Control, Municipal Health Services, Eindhoven, the Netherlands.
authors.forename: Rick H P J
authors.initials: RH
authors.lastname: Daemen
authors.affiliation: Department of Internal Medicine and Infectious diseases, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Joop E
authors.initials: JE
authors.lastname: Arends
authors.affiliation: Department of Gastroenterology and Hepatology, Diakonessen Hospital Utrecht, Utrecht, the Netherlands.
authors.forename: Marc A M T
authors.initials: MA
authors.lastname: Verhagen
authors.affiliation: Departments of Infectious Disease Control, Municipal Health Services, Utrecht, the Netherlands.
authors.forename: Christine
authors.initials: C
authors.lastname: Schout
authors.affiliation: Department of Gastroenterology and Hepatology, Rijnstate Hospital Arnhem, Arnhem, the Netherlands.
authors.forename: B W Marcel
authors.initials: BW
authors.lastname: Spanier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D044466:Asian People; D006528:Carcinoma, Hepatocellular / Q000208:ethnology*; D002681:China / Q000208:ethnology; D003710:Demography; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000208:ethnology*; D006801:Humans; D008103:Liver Cirrhosis / Q000208:ethnology*; D008113:Liver Neoplasms / Q000208:ethnology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D014171:Transients and Migrants; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens
keywords: Chinese migrants; clinical impact; hepatitis B; screening; secondary prevention