{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:12Z","timestamp":1772169132797,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.17941.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000}}],"reference-count":30,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["110110\/Z\/15\/Z"],"award-info":[{"award-number":["110110\/Z\/15\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    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 aimed to i) extract and summarise existing national HBV prevalence estimates, ii) add a new estimate based on primary care data, and; iii) critique data sources from which estimates were derived.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    We undertook a narrative review, searching for national estimates of CHB case numbers in the UK (incorporating incidence, prevalence and\/or test positivity data) across a range of overlapping sources, including governmental body reports, publications from independent bodies (including medical charities and non-governmental organisations) and articles in peer-reviewed scientific journals. \u00a0An alternative proxy for population prevalence was obtained via the UK antenatal screening programme which achieves over 95% coverage of pregnant women. We also searched for diagnoses of HBV in the QResearch primary care database based on laboratory tests and standardised coding.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    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 &lt;0.5%.\u00a0Our estimate, based on QResearch data, suggests a population prevalence of ~0.05%, reflecting a substantial underestimation based on primary care records.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Discussion<\/ns4:bold>\n                    : Estimates varied by sources of error, bias and missingness, data linkage, and \u201cblind spots\u201d in HBV diagnoses testing\/registration. The UK HBV burden is likely to be concentrated in vulnerable populations who may not be well represented in existing datasets including those experiencing socioeconomic deprivation and\/or homelessness, ethnic minorities and people born in high-prevalence countries. This could lead to under- or over-estimation of population prevalence estimation.\u00a0Multi-agency collaboration is required to fill evidence gaps.\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.17941.2","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T11:20:07Z","timestamp":1678360807000},"page":"203","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing?"],"prefix":"10.12688","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5890-7105","authenticated-orcid":false,"given":"Cori","family":"Campbell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8351-9494","authenticated-orcid":false,"given":"Tingyan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebekah","family":"Burrow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sema","family":"Mandal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Hippisley-Cox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0860-0831","authenticated-orcid":false,"given":"Eleanor","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4036-4269","authenticated-orcid":false,"given":"Philippa C","family":"Matthews","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"1683-91","DOI":"10.1001\/jamaoncol.2017.3055","article-title":"The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level: results from the global burden of disease study 2015.","volume":"3","author":"T Akinyemiju","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"245-66","DOI":"10.1016\/S2468-1253(19)30349-8","article-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.","volume":"5","year":"2020","journal-title":"Lancet Gastroenterol Hepatol."},{"key":"ref-3","article-title":"Hepatitis B Fact 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characteristics of a large multi-site chronic HBV electronic health record-based cohort in the UK.","volume":"10","author":"C Campbell","year":"2021","journal-title":"F1000Res."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"101-9","DOI":"10.1097\/MEG.0000000000001537","article-title":"Hepatitis B virus infection and the risk of liver disease progression in type 2 diabetic patients with potential nonalcoholic fatty liver disease: a retrospective, observational, cohort study in the United Kingdom Clinical Practice Research Datalink.","volume":"32","author":"G Ferreira","year":"2020","journal-title":"Eur J Gastroenterol Hepatol."},{"key":"ref-11","article-title":"Demonstrating control of perinatal transmission of hepatitis B in the UK: a low prevalence country with universal antenatal screening and selective neonatal immunisation programmes.","author":"S Mandal","year":"2022"},{"key":"ref-12","doi-asserted-by":"publisher","DOI":"10.1101\/2022.04.12.22273568","article-title":"Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing?","author":"C Campbell","year":"2022","journal-title":"medRxiv."},{"key":"ref-13","article-title":"Annual report from the sentinel surveillance of blood borne virus testing in England 2020: main report","volume":"15","year":"2021"},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"383-403","DOI":"10.1016\/S2468-1253(18)30056-6","article-title":"Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study.","volume":"3","year":"2018","journal-title":"Lancet Gastroenterol Hepatol."},{"key":"ref-15","article-title":"Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2016","year":"2017"},{"key":"ref-16","article-title":"Antenatal screening standards: data report 1 April 2019 to 31 March 2020.","year":"2021"},{"key":"ref-17","article-title":"Hepatitis B","year":"2017"},{"key":"ref-18","article-title":"Hepatitis B: migrant health guide.","year":"2017cited 2022 Feb 8"},{"key":"ref-19","article-title":"Hepatitis B and C testing: people at risk of infection (PH43)","year":"2012 cited 2022 Feb 8"},{"key":"ref-20","article-title":"[ARCHIVED CONTENT] Getting ahead of the curve: a strategy for combating infectious diseases (including other aspects of health protection)."},{"key":"ref-21","article-title":"Characteristics of Chronic Hepatitis B associated with Cirrhosis and Cancer."},{"key":"ref-22","doi-asserted-by":"publisher","first-page":"2402-2413","DOI":"10.1111\/trf.16543","article-title":"Hepatitis B infections among blood donors in England between 2009 and 2018: Is an occult hepatitis B infection a risk for blood safety?","volume":"61","author":"H Harvala","year":"2021 cited 2023 Feb 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England and implications for eliminating HIV transmission by 2030: an evidence synthesis model.","volume":"6","author":"A Presanis","year":"2021","journal-title":"Lancet Public Health."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T09:10:21Z","timestamp":1680513021000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,9]]},"references-count":30,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.17941.2","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.21210.r55464","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.21210.r55465","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.21210.r55465","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.21210.r55464","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,9]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.21210.r55465, Lung-Yi Mak, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, 10 Mar 2023, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v2#referee-response-55465","order":0,"name":"referee-response-55465","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.19882.r53567, Jonggi Choi, Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 03 Jan 2023, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v1#referee-response-53567","order":1,"name":"referee-response-53567","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21210.r55464, Anders Boyd, HIV Monitoring Foundation, Amsterdam, 15 Mar 2023, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/7-203\/v2#referee-response-55464","order":2,"name":"referee-response-55464","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"PCM is funded by Wellcome (grant ref 110110), by the Francis Crick Institute, and by University College London Hospitals NIHR BRC. CC\u2019s doctoral project is funded by the Nuffield Department of Medicine, University of Oxford and by GlaxoSmithKline. EB is funded by the Oxford NIHR Biomedical Research Centre and is an NIHR Senior Investigator. The views expressed in this article are those of the author and not necessarily those of the NHS, the NIHR, or the Department of Health. PCM, EB and CC are supported by the DeLIVER program \u201cThe Early Detection of Hepatocellular Liver Cancer\u201d project is funded by Cancer Research UK (Early Detection Programme Award, grant reference: C30358\/A29725). EB, TW, CC and PCM acknowledge support from the NIHR Health Informatics Collaborative. JH-C is an unpaid director of QResearch, a not-for-profit organisation which is a partnership between the University of Oxford and EMIS Health that supplies the QResearch Database used for this work. JH-C is chair of the NERVTAG subgroup on risk stratification and a member of SAGE groups on data and ethnicity. JH-C is a founder and shareholder of ClinRisk and was its medical director until 31 May 2019. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}