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Objectives: We analyzed hepatitis B surface antigen (HBsAg) screening and seropositivity within a network of 419 general practices representative of all regions of England., Methods: Information was extracted using pseudonymized registration data. Predictors of HBsAg seropositivity were explored in models that considered age, gender, ethnicity, time at the current practice, practice location and associated deprivation index, and presence of nationally endorsed screen indicators including pregnancy, men who have sex with men (MSM), history of injecting drug use (IDU), close HBV contact or imprisonment, and diagnosis of blood-borne or sexually transmitted infections., Results: Among 6,975,119 individuals, 192,639 (2.8 %) had a screening record, including 3.6-38.6 % of those with a screen indicator, and 8065 (0.12 %) had a seropositive record. The odds of seropositivity were highest in London, in the most deprived neighborhoods, among minority ethnic groups, and in people with screen indicators. Seroprevalence exceeded 1 % in people from high-prevalence countries, MSM, close HBV contacts, and people with a history of IDU or a recorded diagnosis of HIV, HCV, or syphilis. Overall, 1989/8065 (24.7 %) had a recorded referral to specialist hepatitis care., Conclusions: In England, HBV infection is associated with poverty. There are unrealized opportunities to promote access to diagnosis and care for those affected., Competing Interests: Conflicts of interests AMG previously served as expert scientist for Roche Pharma Research and Early Development, which included research on the development of curative interventions for chronic HBV infection, and received funding in support of HBV biomarker research (through her institution) from Roche pRED and Roche Diagnostics. SdeL has received funding for vaccine-related research (through his institution) from AstraZeneca, GSK, Sanofi, Seqirus and Takeda (the GSK award relates to hepatitis related research); has been a member of influenza and COVID-19 advisory boards for AstraZeneca, Pfizer, Sanofi and Seqirus; and is Director of the Oxford-RCGP RSC as part of his academic post. HA, GV, CoS, CaS, RB, JS, FF, RB, BM-T and MW have no conflict of interest to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The treatment of hepatitis C virus (HCV) infection has been revolutionised by the advent of oral, well-tolerated, direct acting antiviral therapies (DAA), with high cure rates. However, in some scenarios, HCV resistance to antiviral therapies may have an impact on treatment success. Public Health England's HCV Resistance Group was established to support clinicians treating people with HCV, where the issue of resistance may be a factor in clinical decision-making, and this review includes the Group's current recommendations on the use of HCV resistance testing. The authors describe the principles behind and approach to HCV resistance testing and consider evidence from in vitro studies, clinical trials and real world cohorts on the impact of HCV resistance on treatment outcomes for particular DAA regimens. Five scenarios are identified in the UK and similar settings, where, in the Group's opinion, resistance testing should be performed., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Objective: To evaluate the impact of treatment with new direct-acting antivirals (DAAs) on the prevalent hepatitis C virus (HCV) population in England., Design: A repeated cross-sectional analysis., Setting: Four secondary care hospitals in England., Participants: Patients who, in 2015 and/or 2016, had chronic HCV infection and were alive were eligible, regardless of the type of HCV intervention received., Outcome Measures: Data including intravenous drug use (IVDU) status, HCV genotype, cirrhosis status, HCV treatment history, vital status and treatment outcomes were collected at two time points in 2015 and 2016 using electronic case report forms., Results: There were 1605 and 1355 patients with active chronic HCV in 2015 and 2016, respectively. Between 2015 and 2016, the proportion of patients with current IVDU increased (10.3% vs 14.5%, respectively), while that of patients with cirrhosis (28.2% vs 22.4%) and treatment-experienced patients (31.2% vs 27.1%) decreased. Among patients whose treatment outcome was known by 2016, high cure rates were observed, with an overall sustained virological response rate of 93.2%. From 2015 to 2016, there was a progressive increase in the proportion of treated patients who were non-cirrhotic, with current IVDU and non-liver transplant recipients., Conclusions: The characteristics of patients with HCV remaining in contact with specialised care evolved with a changing landscape of treatment and related health policy. With increasing access to DAAs in UK, high cure rates were achieved in the study cohort., Competing Interests: Competing interests: MH and JG are employees of HEOR. NRH and LL are employees of BMS. LC and YG-D have previously received research funding from AbbVie Pharmaceuticals relevant to HCV. AMG has received consultancy honoraria from Janssen and Cepheid, has been employed by Roche Pharma Research & Early Development (pRED) (no stocks, shares or patents) and has acted as the principal investigator on research grants alongside Janssen, ViiV, BMS and Gilead. RA has served as a speaker or advisory board member for AbbVie Pharmaceuticals, Falk Pharma, Gilead, Intercept, Norgine and Novartis. LM has no conflict of interest. DM has accepted honoraria and has acted as adviser to BMS, Gilead Sciences and AbbVie., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)