Introduction Chronic Hepatitis B Virus (HBV) affects 350 million people worldwide with potential serious consequences. The aim of this study was to measure adherence at Sandwell and West Birmingham Hospitals (SWBH) NHS Trust to recent guidance regarding HBV assessment and treatment.
Methods A retrospective review of the SWBH HBV database (2003–2012) was undertaken. On the basis of European Association for the Study of the Liver (EASL) guidance, attainment of the following outcomes (standard 100%) was calculated: ALT measurement, liver ultrasound (US) examination, HBV DNA measurement, HIV testing, further liver assessment where indicated (using biopsy or Fibroscan) and use of antiviral therapy where indicated.
Results 322 patients with HBV were identified. Attainment of the EASL standards were as follows: ALT measurement 92%, liver US examination 80%, HBV DNA measurement 95%, HIV testing 72%, further liver assessment where indicated 82% and use of antiviral therapy where indicated 100%.
Conclusion In general patients were managed according to EASL guidance. Liver US examination was not 100% mainly because patients failed to attend their appointment. HIV testing was not 100% as routine testing in HBV patients was introduced only in 2008. Further liver assessment with biopsy was deferred in a number of cases after discussion between patient and physician; recent acquisition of a Fibroscan at SWBH should increase the proportion of appropriate patients undergoing further liver assessment. It is encouraging that all patients received antiviral therapy where indicated. It is hoped that data from this review and recent acquisition of a Fibroscan at SWBH Trust will promote improved adherence to guidelines.
Disclosure of Interest None Declared.
AASLD practise guidelines 2009: Chronic Hepatitis B
EASL Clinical Practice Guidelines: management of chronic hepatitis B. European Association For The Study Of The Liver. J Hepatol. 2009 Feb; 50(2):227–42