Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands

Sandra Coenen; Suzanne van Meer; Jan M Vrolijk; Clemens Richter; Karel J van Erpecum; Marijke C Mostert; Irene K Veldhuijzen; Jurriën G P Reijnders; Hanneke van Soest; Kees Dirksen; Joost P H Drenth; René P M Koene; Maaike Bosschart; Pieter Friederich; Martijn J Ter Borg; Rick H P J Daemen; Joop E Arends; Marc A M T Verhagen; Christine Schout; B W Marcel Spanier

doi:10.1111/liv.13125

Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands

Sandra Coenen, Suzanne van Meer, Jan M Vrolijk, Clemens Richter, Karel J van Erpecum, Marijke C Mostert, Irene K Veldhuijzen, Jurriën G P Reijnders, Hanneke van Soest, Kees Dirksen, Joost P H Drenth, René P M Koene, Maaike Bosschart, Pieter Friederich, Martijn J Ter Borg, Rick H P J Daemen, Joop E Arends, Marc A M T Verhagen, Christine Schout, B W Marcel Spanier

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND & AIMS: In low-endemic countries it is debated whether first-generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first-generation Chinese migrants.

METHODS: Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first-generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: (i) antiviral therapy, (ii) strict follow-up because of high hepatitis B DNA levels and/or (iii) surveillance for hepatocellular carcinoma.

RESULTS: In total, 4423 persons participated in the projects of whom 6.0% (n = 264) were HBsAg positive. One hundred and twenty-nine newly diagnosed HBsAg-positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%).

CONCLUSIONS: In our screening project in first-generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three of four analysed HBsAg-positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care.

Original language	English
Pages (from-to)	1425-1432
Number of pages	8
Journal	Liver International
Volume	36
Issue number	10
DOIs	https://doi.org/10.1111/liv.13125
Publication status	Published - 2016

Keywords

Chinese migrants
clinical impact
hepatitis B
screening
secondary prevention

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10.1111/liv.13125

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Coenen, S., van Meer, S., Vrolijk, J. M., Richter, C., van Erpecum, K. J., Mostert, M. C., Veldhuijzen, I. K., Reijnders, J. G. P., van Soest, H., Dirksen, K., Drenth, J. P. H., Koene, R. P. M., Bosschart, M., Friederich, P., Ter Borg, M. J., Daemen, R. H. P. J., Arends, J. E., Verhagen, M. A. M. T., Schout, C., & Spanier, B. W. M. (2016). Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands. Liver International, 36(10), 1425-1432. https://doi.org/10.1111/liv.13125

@article{bfdcd92a86524579b2f52da476166c5a,

title = "Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands",

abstract = "BACKGROUND & AIMS: In low-endemic countries it is debated whether first-generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first-generation Chinese migrants.METHODS: Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first-generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: (i) antiviral therapy, (ii) strict follow-up because of high hepatitis B DNA levels and/or (iii) surveillance for hepatocellular carcinoma.RESULTS: In total, 4423 persons participated in the projects of whom 6.0% (n = 264) were HBsAg positive. One hundred and twenty-nine newly diagnosed HBsAg-positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%).CONCLUSIONS: In our screening project in first-generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three of four analysed HBsAg-positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care.",

keywords = "Chinese migrants, clinical impact, hepatitis B, screening, secondary prevention",

author = "Sandra Coenen and {van Meer}, Suzanne and Vrolijk, {Jan M} and Clemens Richter and {van Erpecum}, {Karel J} and Mostert, {Marijke C} and Veldhuijzen, {Irene K} and Reijnders, {Jurri{\"e}n G P} and {van Soest}, Hanneke and Kees Dirksen and Drenth, {Joost P H} and Koene, {Ren{\'e} P M} and Maaike Bosschart and Pieter Friederich and {Ter Borg}, {Martijn J} and Daemen, {Rick H P J} and Arends, {Joop E} and Verhagen, {Marc A M T} and Christine Schout and Spanier, {B W Marcel}",

note = "{\textcopyright} 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2016",

doi = "10.1111/liv.13125",

language = "English",

volume = "36",

pages = "1425--1432",

journal = "Liver International",

issn = "1478-3223",

publisher = "Wiley-Blackwell",

number = "10",

}

Coenen, S, van Meer, S, Vrolijk, JM, Richter, C, van Erpecum, KJ, Mostert, MC, Veldhuijzen, IK, Reijnders, JGP, van Soest, H, Dirksen, K, Drenth, JPH, Koene, RPM, Bosschart, M, Friederich, P, Ter Borg, MJ, Daemen, RHPJ, Arends, JE, Verhagen, MAMT, Schout, C & Spanier, BWM 2016, 'Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands', Liver International, vol. 36, no. 10, pp. 1425-1432. https://doi.org/10.1111/liv.13125

TY - JOUR

T1 - Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands

AU - Coenen, Sandra

AU - van Meer, Suzanne

AU - Vrolijk, Jan M

AU - Richter, Clemens

AU - van Erpecum, Karel J

AU - Mostert, Marijke C

AU - Veldhuijzen, Irene K

AU - Reijnders, Jurriën G P

AU - van Soest, Hanneke

AU - Dirksen, Kees

AU - Drenth, Joost P H

AU - Koene, René P M

AU - Bosschart, Maaike

AU - Friederich, Pieter

AU - Ter Borg, Martijn J

AU - Daemen, Rick H P J

AU - Arends, Joop E

AU - Verhagen, Marc A M T

AU - Schout, Christine

AU - Spanier, B W Marcel

PY - 2016

Y1 - 2016

N2 - BACKGROUND & AIMS: In low-endemic countries it is debated whether first-generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first-generation Chinese migrants.METHODS: Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first-generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: (i) antiviral therapy, (ii) strict follow-up because of high hepatitis B DNA levels and/or (iii) surveillance for hepatocellular carcinoma.RESULTS: In total, 4423 persons participated in the projects of whom 6.0% (n = 264) were HBsAg positive. One hundred and twenty-nine newly diagnosed HBsAg-positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%).CONCLUSIONS: In our screening project in first-generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three of four analysed HBsAg-positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care.

AB - BACKGROUND & AIMS: In low-endemic countries it is debated whether first-generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first-generation Chinese migrants.METHODS: Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first-generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: (i) antiviral therapy, (ii) strict follow-up because of high hepatitis B DNA levels and/or (iii) surveillance for hepatocellular carcinoma.RESULTS: In total, 4423 persons participated in the projects of whom 6.0% (n = 264) were HBsAg positive. One hundred and twenty-nine newly diagnosed HBsAg-positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%).CONCLUSIONS: In our screening project in first-generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three of four analysed HBsAg-positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care.

KW - Chinese migrants

KW - clinical impact

KW - hepatitis B

KW - screening

KW - secondary prevention

U2 - 10.1111/liv.13125

DO - 10.1111/liv.13125

M3 - Article

C2 - 27001619

SN - 1478-3223

VL - 36

SP - 1425

EP - 1432

JO - Liver International

JF - Liver International

IS - 10

ER -

Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands

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