Introduction Ethnicity is associated with certain HBV phenotypes which in turn affect prognosis.
Methods We performed a search for patients with HBV DNA measured at GSTT(March 2007 to March 2015). sAg+ve patients were analysed for:Ethnic group,HIV,Hep C and D co-infection,eAg status, ALT and viral load. Phenotypes were assigned to patients at diagnosis and at last f/up.ALT cut offs were >30 U/L for men and >20 U/L for females.The American Association for the Study of Liver Disease guidelines divide HBV phenotype into 4 groups although a recent study defined an “Indeterminant” group for patients who do not fit into any phenotype
Results1799 patients were sAg+ve,mean f/up duration was 39.2 months(SD 41.2).45% of the cohort were lost to f/up.47% were male, mean age at diagnosis was 36(No difference between ethnicities).82% were eAg-ve,1.5% Hepatitis D+ve,10% HIV+ve,2% hepatitis C+ve.
49% of the cohort were African/Afro-Caribbean,14% Caucasian,10% Chinese,1.5% South Asian, 2.6% South East Asian(other than Chinese),0.3% Arab,3.4% Mixed,2.3% unknown,6.6% “other”.
The table shows HBV phenotype at diagnosis compared to last f/up in all patients and then according to the 3 main ethnic groups.Rates of seroconversion and treatment are also shown. 90.5% of African/Afro-Caribbeans were eAg-ve compared to 71% of Caucasians and 63.9% of Chinese(P < 0.01).There was an association between the risk of cirrhosis and older age at diagnosis,HIV or Hep C co-infection(P < 0.01).
Comparing the 3 largest ethnic groups only,in 2007,70% were African/Afro-Caribbean,19% Caucasian,11% Chinese compared to 51%,36% and 13% respectively in 2014.
Conclusion Ethnicity is significantly associated with HBV phenotypes with a higher percentage of immunotolerants being Chinese and a higher percentage of African/Afro-Caribbeans being inactive.
Compared to 2007,a higher percentage of HBV patients in 2014 were Caucasian reflecting changes in immigration.This may affect HBV outcomes and demand on Hepatology services.
Disclosure of Interest None Declared
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