Impact of the COVID-19 pandemic on routine surveillance for adults with chronic hepatitis B virus (HBV) infection in the UK

Cori Campbell; Tingyan Wang; David A Smith; Oliver Freeman; Theresa Noble; Kinga A Várnai; Steve Harris; Hizni Salih; Gail Roadknight; Stephanie Little; Ben Glampson; Luca Mercuri; Dimitri Papadimitriou; Christopher R Jones; Vince Taylor; Afzal Chaudhry; Hang Phan; Florina Borca; Josune Olza; Frazer Warricker; Luis Romão; David Ramlakhan; Louise English; Paul Klenerman; Monique I Andersson; Jane Collier; Eleni Nastouli; Salim I Khakoo; William Gelson; Graham S Cooke; Kerrie Woods; Jim Davies; Eleanor Barnes; Philippa C Matthews

doi:10.12688/wellcomeopenres.17522.2

Impact of the COVID-19 pandemic on routine surveillance for adults with chronic hepatitis B virus (HBV) infection in the UK

Wellcome Open Res. 2023 Nov 15:7:51. doi: 10.12688/wellcomeopenres.17522.2. eCollection 2022.

Authors

Cori Campbell^{1

2}, Tingyan Wang^{1

2}, David A Smith³, Oliver Freeman^{2

4}, Theresa Noble^{2

3}, Kinga A Várnai^{2

3}, Steve Harris^{2

5}, Hizni Salih², Gail Roadknight², Stephanie Little², Ben Glampson^{6

7}, Luca Mercuri^{6

7}, Dimitri Papadimitriou^{6

7}, Christopher R Jones⁸, Vince Taylor⁹, Afzal Chaudhry⁹, Hang Phan¹⁰, Florina Borca¹⁰, Josune Olza¹⁰, Frazer Warricker¹¹, Luis Romão¹², David Ramlakhan¹², Louise English¹², Paul Klenerman^{1

13}, Monique I Andersson^{13

14}, Jane Collier¹⁵, Eleni Nastouli¹⁶, Salim I Khakoo¹⁷, William Gelson¹⁸, Graham S Cooke^{6

7

19}, Kerrie Woods^{2

3}, Jim Davies^{2

5}, Eleanor Barnes^{1

3}, Philippa C Matthews^{1

3

13}

Affiliations

¹ Nuffield Department of Medicine, University of Oxford, Oxford, UK.
² NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
³ NIHR Health Informatics Collaborative, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
⁴ Nuffield Department of Population Health, University of Oxford, Oxford, UK.
⁵ Department of Computer Science, University of Oxford, Oxford, UK.
⁶ NIHR Health Informatics Collaborative, Imperial College Healthcare NHS Trust, London, UK.
⁷ NIHR Imperial Biomedical Research Centre, London, UK.
⁸ Department of Infectious Disease, Imperial College London, London, UK.
⁹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
¹⁰ NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹¹ University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹² University College London Hospitals NHS Foundation Trust, London, UK.
¹³ Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
¹⁴ Nuffield Department of Clinical Laboratory Sciences, University of Oxford, Oxford, UK.
¹⁵ Department of Hepatology, John Radcliffe Hospital, Oxford, UK.
¹⁶ Department of Clinical Virology, University College London Hospitals NHS Trust, London, UK.
¹⁷ School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁸ Cambridge Liver Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
¹⁹ Faculty of Medicine, Department of Infectious Disease, Imperial College London, London, UK.

Abstract

Background: To determine the impact of the COVID-19 pandemic on the population with chronic Hepatitis B virus (HBV) infection under hospital follow-up in the UK, we quantified the coverage and frequency of measurements of biomarkers used for routine surveillance (alanine transferase [ALT] and HBV viral load).

Methods: We used anonymized electronic health record data from the National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC) pipeline representing five UK National Health Service (NHS) Trusts.

Results: We report significant reductions in surveillance of both biomarkers during the pandemic compared to pre-COVID-19 years, both in terms of the proportion of patients who had ≥1 measurement annually, and the mean number of measurements per patient.

Conclusions: These results demonstrate the real-time utility of HIC data in monitoring health-care provision, and support interventions to provide catch-up services to minimise the impact of the pandemic. Further investigation is required to determine whether these disruptions will be associated with increased rates of adverse chronic HBV outcomes.

Keywords: COVID-19; HBV; epidemiology; hepatitis B virus; viral hepatitis; virology.

Grants and funding

This work was supported by Wellcome (110110/Z/15/Z, to Philippa C. Matthews). This work has been conducted using National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC) data resources and funded by the NIHR HIC, and has been supported by NIHR Biomedical Research Centres at Cambridge, Imperial, Oxford, Southampton, and University College London Hospitals. GSC is an NIHR research professor, EB is an NIHR senior investigator. PCM holds an NIHR Senior Fellowship award. CC is a doctoral student who receives partial doctoral funding from GlaxoSmithKline (GSK). FW is an NIHR-funded ACF. The views expressed in this letter are those of the authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health.