Campbell, C;
Wang, T;
Gillespie, I;
Barnes, E;
Matthews, PC;
(2024)
Analysis of primary care electronic health record data of people living with hepatitis B virus: infection and hepatocellular carcinoma risk associated with socio-economic deprivation.
Public Health
, 226
pp. 215-227.
10.1016/j.puhe.2023.10.036.
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Abstract
Objectives: We set out to characterise chronic hepatitis B (CHB) in the primary care population in England and investigate risk factors for progression to hepatocellular carcinoma (HCC). // Study design: Retrospective cohort study. // Methods: We identified 8039 individuals with CHB in individuals aged ≥18 years between 1999 and 2019 in the English primary care database QResearch. HCC risk factors were investigated using Cox proportional hazards modelling. // Results: Most of those with a record of CHB were males (60%) of non-White ethnicity (>70%), and a high proportion were in the most deprived Townsend deprivation quintile (44%). Among 7029 individuals with longitudinal data, 161 HCC cases occurred. Increased HCC hazards were significantly associated with male sex (adjusted hazards ratio [aHR] 3.17, 95% confidence interval [95% CI] 1.92–5.23), in the fifth deprivation quintile as compared to the third quintile (aHR 1.69, 95% CI 1.01–2.84), with older age (for age groups 56–65 and ≥66 years, compared to 26–35 years, aHRs 2.82 [95% CI 1.45–5.46] and 3.76 [95% CI 1.79–7.9], respectively), Caribbean ethnicity (aHR 3.32, 95% CI 1.43–7.71, compared to White ethnicity), ascites (aHR 3.15, 95% CI 1.30–7.67), cirrhosis (aHR 6.55, 95% CI 4.57–9.38) and peptic ulcer disease (aHR 2.26, 95% CI 1.45–3.51). // Conclusions: Targeting interventions and HCC surveillance at vulnerable groups is essential to improve CHB outcomes and to support progress towards international goals for the elimination of hepatitis infection as a public health threat.
| Type: | Article |
|---|---|
| Title: | Analysis of primary care electronic health record data of people living with hepatitis B virus: infection and hepatocellular carcinoma risk associated with socio-economic deprivation |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.puhe.2023.10.036 |
| Publisher version: | http://dx.doi.org/10.1016/j.puhe.2023.10.036 |
| Language: | English |
| Additional information: | Copyright © 2023 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| Keywords: | Hepatitis B virus; Epidemiology; Liver cancer; Statins; Electronic health records; Big data; Viral hepatitis elimination |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences 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 |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10184836 |
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