Navigating past and current hepatitis B infection in primary care.

Abstract

Chronic hepatitis B (HBV) infection affects 3.5% of the global population.1 In high-prevalence areas, new infections occur mainly at birth or in childhood. Most HBV in the UK is among migrant populations from areas with high prevalence, such as Sub-Saharan Africa, South-East Asia, and China.2 Health care is increasingly reliant on immune-modulating drugs that can exacerbate a chronic infection or allow a past, ‘cleared’ infection to reactivate. Clinicians may not appreciate the high burden of HBV among certain minority migrant groups, who may themselves have misconceptions regarding personal risk and modes of transmission, and who experience barriers to accessing health care.3 The busy GP needs to know who to test for HBV, how to tell if someone has chronic or past HBV infection, and when past infection may reactivate. Consulting on HBV in primary care may include counselling on transmission risk, vaccinating against HBV, and referring for specialist care. GPs should consider testing all patients who are at ‘increased risk’ of HBV (Box 1).4 Strategies for testing within a general practice population include identifying new registrants with a risk factor for HBV, or proactively identifying existing patients who are at risk either systematically or within a consultation. The yield from systematic testing will be dictated by the demographics of individual patient populations; practices serving migrant populations might consider this a higher priority. | | ||