P92 Patients with Hepatitis B infection are highly represented in deprived areas, less engaged with healthcare and can be rapidly identified using a novel case-finding database to help achieve the Chronic Hepatitis B Elimination 2030 goal

BackgroundHepatitis B virus (HBV) is a global health problem with an estimated 200,000 individuals with chronic HBV in the UK, 95% of which are in immigrant populations. The goal of elimination by 2030 is challenging even in the UK partly because HBV is commoner in deprived areas, and a failure in investigation and referral pathways. In the NHS in England the ‘Core20Plus5’ programme provides a mandate for tackling inequalities. ‘Core20’ refers to individuals in the 20% most deprived areas defined by the Index of Multiple Deprivation (IMD deciles 1 &2). We tested the hypothesis that our novel case-finding database developed in Somerset (covering 0.6m population) could identify HBV infected patients and provide a means to target those in deprived areas.MethodsWe configured our case-finding database to identify adult patients with HBV infection (positive HBV surface antigen). Within the tool, searches were stratified by IMD decile. Patients electronic patient records were reviewed to categorise as follows: 1) no data, 2) out of the area, 3) never referred, 4) never engaged following referral, 5) lost to follow-up (patient disengagement or system issues) and 6) actively followed or treated (chronic HBV or followed to surface antigen loss). Individuals in deprived areas data (IMD deciles 1 & 2) were compared to control (IMD 3 – 10).ResultsCorrecting for the known lower immigrant population we predicted 900 chronic HBV patients in Somerset (estimated 0.45% prevalence within the UK). The case finding database identified 302 HBV+ve patients. A deprivation score was available for 98.8% of the population. 9% of the whole Somerset population came from deprived areas compared to 24% of men and 12% of women with HBV (P