Hepatitis B Virus (HBV) treatment eligibility in the UK: retrospective longitudinal cohort data to explore the impact of changes in clinical guidelines
Campbell, Cori Wang, Tingyan Stockdale, Alexander J Todd, Stacy Jaworski, Jakub Glampson, Ben Papadimitriou, Dimitri Mayer, Erik Salih, Hizni Roadknight, Gail
Campbell, Cori
Wang, Tingyan
Stockdale, Alexander J
Todd, Stacy
Jaworski, Jakub
Glampson, Ben
Papadimitriou, Dimitri
Mayer, Erik
Salih, Hizni
Roadknight, Gail
Affiliation
NIHR Oxford Biomedical Research Centre; University of Oxford; University of Liverpool; Liverpool University Hospitals NHS Trust; Cambridge University Hospitals NHS Foundation Trust; Imperial College Healthcare NHS Trust; Imperial College London; Oxford University Hospitals NHS Foundation Trust; University Hospital Southampton NHS Foundation Trust; University of Southampton; NIHR University College London Hospitals Biomedical Research Centre; UCL Great Ormond Street Institute of Child Health; University College London Hospitals NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust; Francis Crick Institute
Other Contributors
Ryder, Stephen
Easom, Nicholas
Bernal, William
Ahmad, Shazaad
Macdonald, Douglas
Stanworth, Simon
Maynard, Suzanne
Glampson, Ben
Mercuri, Luca
MacNaughton, Heidi
Kim, Yun
Olza Meneses, Josune
Harris, Steve
Roberts, Lara
Vilar, Javier
Norris, Ruth
Tilston, George
Serafimova, Ilina
Montague, Sarah
Verheyden, Juliette
Juurlink, Irene
Jack, Kathryn
Waldren-Glenn, Alex
Poole, Lizzie
Day, Victoria
Reglar, Berit
Easom, Nicholas
Bernal, William
Ahmad, Shazaad
Macdonald, Douglas
Stanworth, Simon
Maynard, Suzanne
Glampson, Ben
Mercuri, Luca
MacNaughton, Heidi
Kim, Yun
Olza Meneses, Josune
Harris, Steve
Roberts, Lara
Vilar, Javier
Norris, Ruth
Tilston, George
Serafimova, Ilina
Montague, Sarah
Verheyden, Juliette
Juurlink, Irene
Jack, Kathryn
Waldren-Glenn, Alex
Poole, Lizzie
Day, Victoria
Reglar, Berit
Publication date
2025-10-23
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Nucleos/tide analogue (NA) drugs are used for long-term treatment of chronic hepatitis B virus (HBV) infection, with treatment eligibility criteria changing rapidly amidst globally evolving clinical guidelines. We aimed to quantify the prescription of NA drugs to date, and to undertake a preliminary assessment of the impact of relaxing treatment eligibility thresholds, leveraging a unique large real-world secondary care dataset. We assimilated longitudinal clinical data, collected between February 1997 and April 2023 from adults with chronic HBV infection from six centres in England through the UK NIHR Health Informatics Collaborative (HIC) Viral Hepatitis and Liver Disease theme. We describe factors currently associated with the receipt of NA treatment and determine the proportion of the population who would become treatment eligible as thresholds change. Across 7558 adults with a mean follow-up of 4.0 years (SD 3.9), NA treatment was prescribed in 2014/7558 (26.6%), and as expected according to guidelines at the time, was associated with HBV e-antigen (HBeAg) positivity and alanine transferase (ALT) above the upper limit of normal (> ULN). Treatment was more likely in males, older adults, in Asian and Other ethnicities (compared to White), and less likely in socioeconomically deprived individuals. The proportion of treatment-eligible individuals was 32.3% based on 2 records of ALT > ULN over 6-12 months, 41.7% based on ALT > ULN and viral load (VL) > 2000 IU/mL, and 95.1% based on detectable VL and either ALT > ULN or age > 30 years. Evolving clinical guidelines will lead to substantial increases in the proportion of individuals living with HBV who are eligible for treatment, underlining the need for services to adapt rapidly to the changing clinical environment.
Citation
Campbell C, Wang T, Stockdale AJ, Todd S, Jaworski J, Glampson B, Papadimitriou D, Mayer E, Salih H, Roadknight G, Little S, Noble T, Várnai KA, Davis C, Heinson AI, George M, Borca F, Roberts T, Ribeyre BB, English L, Zhu L; NIHR HIC Viral Hepatitis and Liver Disease Consortium; Woods K, Davies J, Cooke GS, Nastouli E, Khakoo SI, Gelson W, Elsharkawy AM, Barnes E, Matthews PC. Hepatitis B Virus (HBV) Treatment Eligibility in the UK: Retrospective Longitudinal Cohort Data to Explore the Impact of Changes in Clinical Guidelines. J Viral Hepat. 2025 Nov;32(11):e70098. doi: 10.1111/jvh.70098.
Type
Article