P56 What is the best method of case finding for chronic viral hepatitis in migrant communities?

Abstract

were excluded. 80 (14%) subjects had past infection with HBV (HBsAg negative, HBcAb positive). Individuals with past HBV were significantly older than HBsAg positive and HBsAg, HBcAb negative subjects (p<0.001). The prevalence of HBsAg positivity was highest in subjects born in Vietnam (17.4%, 4/23), followed by China (11.5%, 24/157), Hong Kong (8.3%, 18/288), the UK (6.7%, 5/75) and other (6.2%, 2/32). Only 12% of subjects reported previous vaccination against HBV. To date, 25 of the HBsAg positive individuals have been seen in our clinic. 1 was HBeAg positive (immunotolerant) and 24 were HBeAg negative. Of these, 3 have active disease (including 1 cirrhotic) and have been started on treatment. 14 have inactive cHBV and 7 are undergoing observation to determine disease activity. No cases of co-infection with HCV, HIV or Delta were found. Conclusion 1. Undiagnosed cHBV is common in the British-Chinese community of NE England, including subjects born in the UK. 2. A proportion had active cHBV requiring treatment. 3. If these results were applied to the entire UK British-Chinese population targeted screening should lead to approximately 32 250 newly diagnosed cases of cHBV. 4. These results provide evidence for a UK HBV screening and vaccination program for the British-Chinese community.

Engaging New Migrants in Infectious Disease Screening: A Qualitative Semi-Structured Interview Study of UK Migrant Community Health-Care Leads

“…We have found that data from innovative locally tested screening initiatives are often not published so the benefits of these approaches remain unclear. Conversely, international studies have reported unsuccessful community-based collaborations, in terms of uptake [41] and cost-effectiveness [42] . The Migrant-Friendly Hospitals Initiative, which resulted in The Amsterdam Declaration (Towards Migrant-Friendly Hospitals in an Ethno-culturally diverse Europe) in 2004, specifically calls for service providers to focus on developing partnerships with local community-based organisations with a view to improving service delivery to migrant groups [43] .…”

Case-finding for hepatitis C in primary care: a mixed-methods service evaluation

“…10,11 It is known that targeted case-finding of at-risk groups increases test uptake and diagnosis of asymptomatic patients, and is more effective than opportunistic testing alone. [12][13][14][15][16][17][18] Guidance from the Royal College of General Practitioners (RCGP) on HCV management advocates the testing of patients who are at risk within primary care. 19 Barriers to testing include:…”

Assessing the cost‐effectiveness of finding cases of hepatitis C infection inUKmigrant populations and the value of further research

“…A small number of hepatitis case‐finding methods have been studied in UK migrant populations , as identified in a recent systematic review . This analysis, however, was based on a recent approach in which Pakistani/British Pakistani people registered at general practices (GPs) in London were written to and invited to ‘opt‐out’ of being tested for hepatitis B and C infection.…”

“…Those who did not opt‐out were telephoned and asked to attend a clinic for a test. Although only an abstract was available, it was the most recent HCV study to be identified and was UK based . The comparator programme was defined as the background likelihood of testing or ‘no intervention’.…”

“…The probability of testing in the intervention arm was based on the recent ‘opt‐out’ option described by Lewis et al . . Approximately 20% (223/1134) of all eligible individuals were tested; many GP records did not contain up‐to‐date contact details largely explaining the modest uptake.…”