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Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing? [version 1; peer review: 1 approved, 2 approved with reservations]

Campbell, Cori; Wang, Tingyan; Burrow, Rebekah; Mandal, Sema; Hippisley-Cox, Julia; Barnes, Eleanor; Matthews, Philippa C; (2022) Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing? [version 1; peer review: 1 approved, 2 approved with reservations]. F1000 Research Ltd Green open access

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Abstract

Background: HBV is the leading global cause of cirrhosis and primary liver cancer. However, the UK HBV population has not been well characterised, and estimates of UK HBV prevalence and/or incidence vary widely between sources. We summarised datasets that are available to represent UK CHB epidemiology, considering differences between sources, and discussing deficiencies in current estimates. Methods: We searched for estimates of CHB case numbers in the UK (incorporating incidence and/or prevalence-like data) across a range of available sources, including UK-wide reports from government bodies, publications from independent bodies (including medical charities and non-governmental organisations) and articles in peer-reviewed scientific journals to collate estimated positivity rates. An alternative proxy for population prevalence was obtained via the UK antenatal screening programme which achieves over 95% coverage of pregnant women. Results: We identified six CHB case number estimates, of which three reported information concerning population subgroups, including number of infected individuals across age, sex and ethnicity categories. Estimates among sources reporting prevalence varied from 0.27% to 0.73%, congruent with an estimated antenatal CHB prevalence of <0.5%. Discussion: Estimates varied by sources of error, bias and missingness, data linkage, and substantial “blind spots” in consistent testing and registration of HBV diagnoses. The HBV burden in the UK is likely to be concentrated in vulnerable populations who may not be well represented in existing datasets including those experiencing socioeconomic deprivation, ethnic minorities, people experiencing homelessness and people born in high-prevalence countries. Together, these factors could lead to either under- or over-estimation of overall prevalence, and additional efforts are required to provide estimates that best reflect the whole population. Multi-parameter evidence synthesis and back-calculation model methods similar to those used to generate estimates of HCV ad HIV population-wide prevalence may be applicable to HBV.

Type: Working / discussion paper
Title: Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing? [version 1; peer review: 1 approved, 2 approved with reservations]
Open access status: An open access version is available from UCL Discovery
DOI: 10.12688/wellcomeopenres.17941.1
Publisher version: https://doi.org/10.12688/wellcomeopenres.17941.1
Language: English
Additional information: Copyright: © 2022 Campbell C et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: hepatitis B virus, HBV, prevalence, epidemiology
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10154269
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