Tracking the uptake of outcomes of hepatitis B virus testing using laboratory data in Victoria, 2011–16: a population-level cohort study
Caroline van Gemert A B H , Wayne Dimech C , Mark Stoove A B , Rebecca Guy D , Jess Howell A E , Scott Bowden F , Suellen Nicholson F , Stella Pendle G , Basil Donovan D , Margaret Hellard A B and on behalf of the ACCESS collaboration*A Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
B Department of Epidemiology and Preventative Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, Vic. 3004, Australia.
C NRL, 4th Floor, Healy Building, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia.
D The Kirby Institute, UNSW Australia, Wallace Wurth Building, Sydney, NSW 2052, Australia.
E Department of Medicine, The University of Melbourne, Vic. 3010, Australia.
F Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Vic. 3000, Australia.
G Australian Clinical Labs, 14 Lexington Drive, Bella Vista, NSW 2153, Australia.
H Corresponding author. Email: caroline.vangemert@burnet.edu.au
Sexual Health 16(4) 358-366 https://doi.org/10.1071/SH18102
Submitted: 22 May 2018 Accepted: 14 March 2019 Published: 1 July 2019
Abstract
Background: A priority area in the 2016 Victorian Hepatitis B Strategy is to increase diagnostic testing. This study describes hepatitis B testing and positivity trends in Victoria between 2011 and 2016 using data from a national laboratory sentinel surveillance system. Methods: Line-listed diagnostic and monitoring hepatitis B testing data among Victorian individuals were collated from six laboratories participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) of sexually transmissible infections and blood-borne viruses. Diagnostic tests included hepatitis B surface antigen (HBsAg)-only tests and guideline-based hepatitis B tests (defined as a single test event for HBsAg, hepatitis B surface antibody and hepatitis B core antibody). Using available data, the outcomes of testing and/or infection were further classified. Measures reported include the total number of HBsAg and guideline-based tests conducted and the proportion positive, classified as either HBsAg positive or chronic hepatitis B infection. Results: The number of HBsAg tests decreased slightly each year between 2011 and 2016 (from 91 043 in 2011 to 79 664 in 2016; P < 0.001), whereas the number of guideline-based hepatitis B tests increased (from 8732 in 2011 to 16 085 in 2016; P <0.001). The proportion of individuals classified as having chronic infection decreased from 25% in 2011 to 7% in 2016, whereas the proportion classified as susceptible and immune due to vaccination increased (from 29% to 39%, and from 27% to 34%, respectively; P < 0.001). Conclusions: The study findings indicate an increased uptake of guideline-based hepatitis B testing. The ongoing collection of testing data can help monitor progress towards implementation of the Victorian Hepatitis B Strategy.
Additional keywords: communicable disease control, surveillance, viral hepatitis.
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