Self-reported patient history to assess hepatitis B virus serological status during a large screening campaign

Abstract

When assessing hepatitis B virus (HBV) status in clinical settings, it is unclear whether self-reports on vaccination history and previous HBV-test results have any diagnostic capacity. Of 3997 participants in a multi-centre HBV-screening study in Paris, France, 1090 were asked questions on their last HBV-test result and vaccination history. Discordance between self-reported history compared with infection status (determined by serology) was calculated for participants claiming ‘negative’, ‘effective vaccine’, ‘past infection’, or ‘chronic infection’ HBV-status. Serological testing revealed that 320 (29.4%) were non-immunised, 576 (52.8%) were vaccinated, 173 (15.9%) had resolved the infection and 21 (1.9%) were hepatitis B surface antigen positive. In total 208/426 (48.8%) participants with a self-reported history of ‘negative’ infection had a discordant serological result, in whom 128 (61.5%) were vaccinated and 74 (35.6%) had resolved infections. A total of 153/599 (25.5%) participants self-reporting ‘effective vaccine’ had a discordant serological result, in whom 100 (65.4%) were non-immunised and 50 (32.7%) were resolved infections. Discordance for declaring ‘past’ or ‘chronic infection’ occurred in 9/55 (16.4%) and 3/10 (30.0%) individuals, respectively. In conclusion, self-reported HBV-status based on participant history is partially inadequate for determining serological HBV-status, especially between negative/vaccinated individuals. More adapted patient education about HBV-status might be helpful for certain key populations.

HCV and HBV prevalence based on home blood self-sampling and screening history in the general population in 2016: contribution to the new French screening strategy

“…Indeed, based on declarative data, an estimated 85% of the general population aged 15-75 years have never been tested for all three diseases (33% have never been tested for any of the three). Given the probable poor reliability of self-reported HCV and HBV statuses (42,43), this estimate most likely does not reflect the true proportion of individuals who have not been tested for all three viruses. However, if the HAS recommends this strategy, its practical implementation by physicians will rely on patients' self-reported history of HCV/HBV/HIV screening.…”

HCV and HBV prevalence based on home blood self-sampling and screening history in the general population in 2016: contribution to the new French screening strategy

“…Indeed, based on declarative data, an estimated 85% of the general population aged 15-75 years have never been tested for all three diseases (33% have never been tested for any of the three). Given the probable poor reliability of self-reported HCV and HBV statuses [43,44], this estimate most likely does not reflect the true proportion of individuals who have not been tested for all three viruses. However, if the HAS recommends this strategy, its practical implementation by physicians will rely on patients' self-reported history of HCV/HBV/HIV screening.…”

Hepatitis B Vaccination Coverage in Germany: Systematic Review

“…groups of people with a certain migrational background) cannot be derived from these samples. Many of the studies obtained data on vaccination status from self-reports, which have low validity and lead to an overestimation of VC (86,(89)(90)(91). Also, results obtained from serology without further information on past immunisation only provide information on a current titre.…”