PMID- 28596186
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2291-0026 (Print)
IS  - 2291-0026 (Electronic)
IS  - 2291-0026 (Linking)
VI  - 5
IP  - 2
DP  - 2017 Jun 6
TI  - Hepatitis B virus testing and linkage to care in a Canadian urban tertiary 
      referral centre: a retrospective cohort study.
PG  - E431-E436
LID - 10.9778/cmajo.20170002 [doi]
AB  - BACKGROUND: Despite universal vaccination, chronic hepatitis B virus (HBV) 
      infection remains a public health concern in North America owing to immigration. 
      We aimed to characterize the number of people with a positive result of testing 
      for HBV surface antigen (HBsAg) in Calgary, a large urban Canadian health care 
      region, and to assess whether recommended laboratory tests and specialist 
      consultation were done for those identified as HBsAg-positive. METHODS: Based on 
      laboratory and Alberta Health Services administrative data, we identified all 
      adults (age > 18 yr) with a positive HBsAg test result from Jan. 1 to Dec. 31, 
      2014 within the Calgary Zone. Demographic and relevant laboratory data were 
      extracted within 6 months of a positive HBsAg test result, and referral to 
      hepatology (2011-2014) was identified from data on referral to a centralized 
      clinic. Parametric and nonparametric statistical methods were used for analyses. 
      RESULTS: We identified 1214 HBsAg-positive people (584 women [48.1%]; median age 
      44 [interquartile range (IQR) 36-55] yr). A total of 1192 people (98.2%) had 
      alanine aminotransferase testing (median level 23 [IQR 16-34] U/L; 117 [9.8%] 
      with elevated levels), 682 (56.2%) had testing for HBV DNA (median level 2.8 [IQR 
      2.1-3.8] logIU/mL), 630 (51.9%) had HBV e antigen testing (negative result in 548 
      [87.0%]), and 145 (11.9%) had HBV e antibody testing (positive result in 111 
      [76.6%]). Overall, 144 people (11.9%) received anti-HBV treatment, and 390 
      (32.1%) were referred to a hepatologist. INTERPRETATION: Many HBsAg-positive 
      people in Calgary did not receive the recommended laboratory assessments. The 
      results highlight the necessity of continual public health efforts to screen for 
      chronic HBV infection in Canada and to ensure adequate follow-up in order to 
      reach the World Health Organization's goal of viral hepatitis elimination by 
      2030.
CI  - Copyright 2017, Joule Inc. or its licensors.
FAU - Lau, Keith C K
AU  - Lau KCK
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Shaheen, Abdel Aziz
AU  - Shaheen AA
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Aspinall, Alexander A
AU  - Aspinall AA
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Ricento Ba, Tazuko
AU  - Ricento Ba T
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Qureshi Mba, Kamran
AU  - Qureshi Mba K
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Congly, Stephen E
AU  - Congly SE
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Borman, Meredith A
AU  - Borman MA
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Jayakumar, Saumya
AU  - Jayakumar S
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Eksteen, Bertus
AU  - Eksteen B
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Lee, Samuel S
AU  - Lee SS
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Stinton, Laura
AU  - Stinton L
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Swain, Mark G
AU  - Swain MG
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Burak, Kelly W
AU  - Burak KW
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
FAU - Coffin, Carla S
AU  - Coffin CS
AD  - Affiliations: Calgary Liver Unit (Lau, Shaheen, Aspinall, Congly, Borman, 
      Jayakumar, Eksteen, Lee, Stinton, Swain, Burak, Coffin), Division of 
      Gastroenterology and Hepatology, Department of Medicine; Department of 
      Microbiology, Immunology and Infectious Diseases (Lau, Coffin), Cumming School of 
      Medicine, University of Calgary; Alberta Health Services (Ricento, Qureshi), 
      Calgary, Alta.
LA  - eng
PT  - Journal Article
PL  - Canada
TA  - CMAJ Open
JT  - CMAJ open
JID - 101620603
PMC - PMC5498308
COIS- Competing interests: See the end of the article.
EDAT- 2017/06/10 06:00
MHDA- 2017/06/10 06:01
PMCR- 2017/04/01
CRDT- 2017/06/10 06:00
PHST- 2017/06/10 06:00 [entrez]
PHST- 2017/06/10 06:00 [pubmed]
PHST- 2017/06/10 06:01 [medline]
PHST- 2017/04/01 00:00 [pmc-release]
AID - 5/2/E431 [pii]
AID - 20170002 [pii]
AID - 10.9778/cmajo.20170002 [doi]
PST - ppublish
SO  - CMAJ Open. 2017 Jun 6;5(2):E431-E436. doi: 10.9778/cmajo.20170002.