Article Text

Download PDFPDF
Contribution of sexual health services to hepatitis B detection and control (Netherlands, 2008–2016)
  1. Stijn Raven1,2,
  2. Jeannine Hautvast3,
  3. Wing-Kee Yiek3,
  4. Irene Veldhuijzen1,
  5. Jim van Steenbergen1,4,
  6. Fleur van Aar1,
  7. Christian J P A Hoebe5,6
  1. 1Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  2. 2Infectious Diseases, Public Health Service Region Utrecht, Zeist, The Netherlands
  3. 3Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
  4. 4Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
  5. 5Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Services, Heerlen, The Netherlands
  6. 6Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
  1. Correspondence to Dr Stijn Raven, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands; stijn.raven{at}radboudumc.nl

Abstract

Objectives Case finding is one of the priority actions to reduce the disease burden of chronic hepatitis B (CHB). We estimated the contribution of CHB case finding at sexual health centres (SHCs) to the total national number of newly diagnosed CHB cases in the Netherlands and determined the characteristics of CHB cases detected at SHCs.

Methods This observational study used surveillance data from all outpatient SHCs in the Netherlands (SOAP database) and the number of CHB from national notification data (Osiris) from 2008 to 2016. The proportion of CHB notifications (hepatitis B surface antigen positive serology) detected at SHCs was calculated. SHC consultations without hepatitis B virus (HBV) testing (n=669 308), with acute hepatitis B diagnosis (n=73), with HBV vaccination only (n=182) or an inconclusive hepatitis B diagnosis (n=24) were excluded. Univariable and multivariable logistic regression analyses were performed, stratified by gender and sexual preference, to analyse patient characteristics associated with CHB.

Results During the study period, 12 149 CHB cases were notified. 405 646 SHC consultations were included in the analysis and 1452 CHB cases (0.4%) were detected at SHCs. The proportion of CHB cases detected at SHCs in relation to the national notified number ranged between 12.4% (200 of 1613) in 2008 and 10.8% (106 of 980) in 2016. 87% of CHB cases were among first-generation migrants (FGMs) originating from high endemic countries for sexually transmitted infections or men who have sex with men (MSM). In multivariable analysis, an older age category, migration background and being a commercial sex worker (CSW) were associated with CHB in all stratified analyses.

Conclusions The contribution of SHCs is relevant to case finding of CHB in the Netherlands. SHCs should therefore be considered as an important health setting to screen for HBV in high-risk groups, especially among MSM, CSW and FGM, to achieve a reduction in the HBV-related disease burden.

  • HEPATITIS B
  • Preventive Health Services
  • PUBLIC HEALTH

Data availability statement

Data are available upon reasonable request. The study protocol, raw data and code are available on reasonable request. Data are available on reasonable request, and can be requested by email to the corresponding author.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available upon reasonable request. The study protocol, raw data and code are available on reasonable request. Data are available on reasonable request, and can be requested by email to the corresponding author.

View Full Text

Footnotes

  • Handling editor Mark Charles Atkins

  • Contributors SR, FvA, W-KY, JH, JvS and CJPAH contributed to the study concept and design. SR and W-KY performed the data analysis. SR and W-KY drafted the manuscript. SR took full responsibility for the work, had access to the data, and controlled the decision to publish. All authors critically revised the manuscript and approved the final version for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.