Factors affecting public health follow up of acute hepatitis B cases in England

Objectives: Acute hepatitis B affects over a million people a year globally. Follow up for public health purposes involves vaccination or advising prophylaxis of contacts to reduce transmission. Those lost to follow up are more likely to transmit infection. This study investigated the socio-demographic factors potentially associated with being lost to public health follow up in cases with acute hepatitis B infection. Study design: This was a retrospective cohort study of all acute hepatitis B cases in England followed up by UKHSA in 2022 and 2023. Methods: We reviewed case notes from the UKHSA case management system. The outcome variable was the completion of public health follow up. Independent variables were index of multiple deprivation quintile, age, gender, ethnicity, history of sex between men or sex between women, intravenous drug usage, and geographical region. Results: Out of 226 cases with acute hepatitis B infection, 6.6 % of cases were lost to follow up. Exploratory analyses suggested that males and cases in two regions may be at greater risk of being lost to follow up, although these findings were based on small numbers. Conclusions: This study found that in England most cases of acute hepatitis B are appropriately followed up from a public health perspective. The study suggests that males had a marginally increased risk of being lost to follow up.