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Liver
Undiagnosed chronic hepatitis B is prevalent in the british-chinese community of the north east (NE) of england
  1. S Mcpherson *1,2,
  2. M Valappil3,
  3. S Moses3,
  4. G Eltringham3,
  5. C Miller1,
  6. K Baxter1,
  7. B Brown4,
  8. P Clapper4,
  9. A Chan5,
  10. M Hudson1,2,
  11. M Bassendine1,2
  1. 1Liver Unit, Freeman Hospital, UK
  2. 2Institute of Cellular Medicine, Newcastle University, UK
  3. 3Health Protection Agency, Newcastle upon Tyne, UK
  4. 4Health Protection Agency, Manchester, UK
  5. 5Chinese Healthy Living Centre, Newcastle upon Tyne, UK

Abstract

Introduction Chronic hepatitis B (HBV) is highly prevalent in China and the Far East (>8% seroprevalence). AASLD guidelines1 recommend HBV screening and vaccination in subjects born in high (>8%) or intermediate (2–7%) endemic areas. However, there are no current UK guidelines. The study aim was to apply AASLD recommendations locally to the community with the highest endemicity – British Chinese (estimated population 430 000).

Methods Members of the NE Chinese community were invited to attend screening sessions at the Newcastle Chinese Healthy Living Centre. Dry blood spots were obtained by finger prick and tested for HBsAg and HBcAb (Abbott ARCHITECT). HBsAg positive individuals were advised to undergo confirmatory testing and be referred for specialist assessment.

Results 315 subjects were screened (mean age 52±18 years, 63% female). 31 (10%) were HBsAg positive (48% female) indicating chronic HBV. Of these, 7 reported being previously diagnosed with HBV, but were not under follow-up. When previously diagnosed individuals were excluded the prevalence of HBsAg positivity was 8%. 50 (16%) subjects were HBsAg negative and HBcAb positive indicating past HBV infection. HBsAg positive individuals were significantly younger than HBcAb and negative subjects (44±12 vs 59±15 vs 52±19 years, p<0.001). HBsAg individuals were most commonly born in China (52%), followed by Hong Kong (19%), Vietnam (13%), UK (10%), Macau (3%) and Malaysia (3%). The prevalence of HBsAg positivity for subjects born in China was 12% (16/129), Hong Kong 5% (6/126), Vietnam 18% (4/22) and UK 18% (3/17). Only 8% of subjects in the study reported previous vaccination against HBV.

Conclusion (1) Undiagnosed chronic Hepatitis B is highly prevalent in British-Chinese in NE England, including subjects born in the UK. (2) The frequency of previous HBV vaccination was low in this high risk group. (3) These results provide evidence for a UK HBV screening and vaccination program for the British Chinese community, which is the largest in Europe and is the fastest growing non-European ethnic group in the UK.

  • hepatitis b
  • screening.

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Footnotes

  • Funding Gilead Fellowship Grant.

  • Competing interests None.

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