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]
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 epidemiolo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wellcome
2022-08-01
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| Series: | Wellcome Open Research |
| Subjects: | |
| Online Access: | https://wellcomeopenresearch.org/articles/7-203/v1 |
| _version_ | 1797955514301153280 |
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| author | Tingyan Wang Philippa C Matthews Julia Hippisley-Cox Eleanor Barnes Cori Campbell Sema Mandal Rebekah Burrow |
| author_facet | Tingyan Wang Philippa C Matthews Julia Hippisley-Cox Eleanor Barnes Cori Campbell Sema Mandal Rebekah Burrow |
| author_sort | Tingyan Wang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T23:34:20Z |
| format | Article |
| id | doaj.art-c5499d9d1927403cb630c59592db3c56 |
| institution | Directory Open Access Journal |
| issn | 2398-502X |
| language | English |
| last_indexed | 2024-04-10T23:34:20Z |
| publishDate | 2022-08-01 |
| publisher | Wellcome |
| record_format | Article |
| series | Wellcome Open Research |
| spelling | doaj.art-c5499d9d1927403cb630c59592db3c562023-01-12T01:00:00ZengWellcomeWellcome Open Research2398-502X2022-08-01719882Estimating 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]Tingyan Wang0https://orcid.org/0000-0002-8351-9494Philippa C Matthews1https://orcid.org/0000-0002-4036-4269Julia Hippisley-Cox2Eleanor Barnes3Cori Campbell4https://orcid.org/0000-0001-5890-7105Sema Mandal5Rebekah Burrow6Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3XY, UKOxford Biomedical Research Centre, Oxford, UKQResearch / Nuffield Dept of Primary Care, Oxford, UKOxford Biomedical Research Centre, Oxford, UKNuffield Department of Medicine, University of Oxford, Oxford, OX1 3XY, UKBlood safety, Hepatitis, STI & HIV Division,, UK Health Security Agency, London, UKQResearch / Nuffield Dept of Primary Care, Oxford, UKBackground: 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.https://wellcomeopenresearch.org/articles/7-203/v1hepatitis B virus HBV prevalence epidemiologyeng |
| spellingShingle | Tingyan Wang Philippa C Matthews Julia Hippisley-Cox Eleanor Barnes Cori Campbell Sema Mandal Rebekah Burrow 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] Wellcome Open Research hepatitis B virus HBV prevalence epidemiology eng |
| 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] |
| title_full | 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] |
| title_fullStr | 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] |
| title_full_unstemmed | 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] |
| title_short | 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] |
| title_sort | 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 |
| topic | hepatitis B virus HBV prevalence epidemiology eng |
| url | https://wellcomeopenresearch.org/articles/7-203/v1 |
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