The Diversity and Management of Chronic Hepatitis B Virus Infections in the United Kingdom: A Wake-up Call

被引：32

作者：

Tedder, Richard S. ^{[1
,2
]}

Rodger, Alison J. ^{[3
]}

Fries, Lofi ^{[3
]}

Ijaz, Samreen ^{[1
]}

Thursz, Mark ^{[4
]}

Rosenberg, William ^{[5
]}

Naoumov, Nikolai ^{[6
,7
]}

Banatvala, Jangu ^{[8
]}

Williams, Roger ^{[6
,7
]}

Dusheiko, Geoffrey ^{[5
]}

Chokshi, Shilpa ^{[6
,7
]}

Wong, Terry ^{[8
]}

Rosenberg, Gillian ^{[1
]}

Moreea, Sulleman ^{[9
]}

Bassendine, Margaret ^{[10
]}

Jacobs, Michael

Mills, Peter R. ^{[11
]}

Mutimer, David ^{[12
]}

Ryder, Stephen D. ^{[13
]}

Bathgate, Andrew ^{[14
]}

Hussaini, Hyder ^{[15
]}

Dillon, John F. ^{[16
]}

Wright, Mark ^{[17
]}

Bird, George ^{[18
]}

Collier, Jane ^{[19
]}

Anderson, Michael ^{[20
]}

Johnson, Anne M. ^{[3
]}

机构：

[1] Hlth Protect Agcy, Microbiol Serv Colindale, London, England

[2] UCL, Div Infect & Immun, London NW3 2PF, England

[3] UCL, Res Dept Infect & Populat Hlth, London NW3 2PF, England

[4] St Marys Hosp, London, England

[5] UCL, Ctr Hepatol, Div Med, London NW3 2PF, England

[6] Inst Hepatol, London, England

[7] Fdn Liver Res, London, England

[8] Guys & St Thomas Hosp, London SE1 9RT, England

[9] Bradford Teaching Hosp NHS Fdn Trust, Bradford, W Yorkshire, England

[10] Freeman Rd Hosp, Newcastle Upon Tyne NE7 7DN, Tyne & Wear, England

[11] Gartnavel Royal Hosp, Glasgow, Lanark, Scotland

[12] Queen Elizabeth Hosp, Birmingham B15 2TH, W Midlands, England

[13] Nottingham Univ Hosp NHS Trust, Truro, England

[14] Royal Infirm Edinburgh NHS Trust, Truro, England

[15] Royal Cornwall Hosp, Truro, England

[16] Ninewells Hosp, Dundee DD1 9SY, Scotland

[17] Southampton Gen Hosp, Southampton SO9 4XY, Hants, England

[18] Maidstone Hlth Author, Maidstone, Kent, England

[19] John Radcliffe Infirm, Oxford, England

[20] Chelsea & Westminster Hosp, London, England

来源：

CLINICAL INFECTIOUS DISEASES | 2013年 / 56卷 / 07期

关键词：

hepatitis B virus; virology; genotypes; clinical outcomes; cross-sectional; NATURAL-HISTORY; HEPATOCELLULAR-CARCINOMA; MUTATIONS; HBV; LAMIVUDINE; SECRETION; GENOTYPES; ENGLAND; PROTEIN; RISK;

D O I：

10.1093/cid/cis1013

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Through migration, diversity of chronic hepatitis B virus (HBV) infection has changed, affecting disease burden and control. We describe clinical and viral characteristics of chronic HBV in the United Kingdom. Methods. A total of 698 individuals with chronic HBV infection were recruited from referral liver centers. Demographic, clinical, and laboratory data were collected. Results. Sixty-one percent of patients were male, 80% were not born in the United Kingdom, and the largest ethnicity was East/Southeast Asian (36%). Twenty-two percent were hepatitis B e antigen (HBeAg) seropositive; 20.4% (59/289) had cirrhosis and 10 (1.7%) had hepatocellular carcinoma. Genotype D was most common (31%) followed by A, C, B, and E (20%, 20%, 19%, and 9%, respectively). Genotype was significantly associated with country of birth, length of time in the United Kingdom, HBeAg status, and precore and basal core promoter mutations. One-third were on treatment, with men independently more likely to be treated. Only 18% of those on treatment were on recommended first-line therapies, and 30% were on lamivudiale monotherapy. Among treated individuals, 27% had antiviral drug resistance. Testing rates for human immunodeficiency virus, hepatitis C virus, and delta coinfections were low. Conclusions. We demonstrated diversity of chronic HBV infections in UK patients, suggesting that optimal management requires awareness of the variable patterns of chronic HBV in countries of origin. We also found less-than-optimal clinical management practices, possible gender-based treatment bias, and the need to improve testing for coinfections.

引用

页码：951 / 960

页数：10

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