Baseline characteristics of a large multi-site chronic HBV electronic health record-based cohort in the UK
Creators: name: Campbell, Cori
name: Tingyan Wang
name: Barnes, Eleanor
name: Matthews, Philippa C.
Publisher: name: F1000 Research Limited
Year: 2021

description: Introduction: Nearly 300 million people worldwide are chronically infected with hepatitis B virus (HBV), which is the leading cause of global liver cancer deaths (1). The UK HBV population is not well characterised but understanding the burden of disease is crucial to optimise case finding and clinical service provision.<br> <br> Aim: We aimed to characterise the English CHB population using a representative sample of patients from the QResearch primary care electronic health record (EHR) database in England (2).<br> <br> Method: We included CHB patients from QResearch, a primary-care database in England of individual-level patient records from 1727 general practices, aged ≥ 18 years with a diagnostic record of CHB between 1999 and 2019. Baseline was defined as the first record of CHB.<br> <br> Results: We identified 7952 CHB patients (61% male). Mean follow-up was 7.3 years. At baseline, 74% of patients were aged &lt; 45 years, 44% were residing in the most deprived geographical regions, and &gt; 50% were non-white. 1.8%, 2.9% and 3.7% of patients had record of non-alcoholic fatty liver disease (NAFLD), cirrhosis and varices/ascites, respectively. Prevalence of extra-hepatic comorbidities was low, however 9.5% and 5.8% of patients had hypertension and diabetes, respectively. Male sex and ethnicity were significantly associated with deprivation (p &lt; 0.001). Within 3 years of diagnosis 145 (1.8%) patients were on antiviral treatment.<br> <br> Conclusions: The UK CHB morbidity burden is concentrated in young, deprived, nonwhite individuals among whom a minority are treated. Further research is required to identify factors associated with different disease outcomes and to assess benefits of wider treatment.<br> <br> Acknowledgements: This project involves data derived from patient-level information collected by the NHS, as part of the care and support of cancer patients. The data is collated, maintained and quality assured by the National Cancer Registration and Analysis Service, which is part of Public Health England (PHE). Access to the data was facilitated by the PHE Office for Data Release. We acknowledge the contribution of EMIS practices who contribute to QResearch® and EMIS Health and the CHANCELLOR MASTERS AND SCHOLARS OF THE UNIVERSITY OF OXFORD for expertise in establishing, developing and supporting the QResearch database. Public Health England bear no responsibility for the analysis or interpretation of the data. Cori Campbell acknowledges doctoral funding from the Nuffield Department of Medicine, University of Oxford and GlaxoSmithKline. Philippa C. Matthews acknowledges funding from theWellcome Trust (grant no. 1101).<br> <br> References:<br> 1. <b>Fitzmaurice C et al.</b> The burden of primary liver cancer and underlying aetiologies from 1990 to 2015 at the global, regional, and national level results from the global burden of disease study 2015. JAMA Oncol 2017;3(12):1683–91.<br> 2. QResearch Database [Internet]. Available from: https://www.qresearch.org/