Clinical Scorecard: Effects of the COVID-19 Pandemic on Hepatitis B Testing in British Columbia, Canada: An Interrupted Time Series Study
At a Glance
Category
Detail
Condition
Hepatitis B virus (HBV) infection
Key Mechanisms
Disruption of healthcare services due to COVID-19 pandemic and related policies leading to reduced HBV testing (HBsAg, HBV DNA, HBeAg)
Target Population
General population of British Columbia, Canada, including people who inject drugs (PWID), pregnant women, and other risk groups
Care Setting
Provincial public health and laboratory testing services in British Columbia
Key Highlights
HBsAg testing decreased by 16.5% and HBV DNA testing decreased by 11.6% in June–December 2020 compared to predicted levels.
Testing reductions persisted throughout 2021 and 2022, remaining lower than predicted.
PWID experienced greater reductions in HBV DNA testing (30.0% vs 11.2% in non-PWID) during 2020 and thereafter.
Guideline-Based Recommendations
Diagnosis
Universal HBV testing recommended during pregnancy.
One-time HBV testing recommended for immigrants from HBV-endemic countries.
Testing recommended for groups with HBV risk factors including PWID, persons born 1945–1965, incarcerated individuals, Indigenous people, and men who have sex with men.
Management
Ensure linkage to care for individuals diagnosed with HBV, especially PWID.
Maintain viral suppression through effective treatments.
Monitoring & Follow-up
Monitor HBV testing rates over time to identify disruptions.
Use population-level data to assess impact of public health emergencies on testing.
Risks
Reduced HBV testing may delay diagnosis and treatment, increasing morbidity and mortality.
PWID are disproportionately affected by testing reductions and may face higher risk of HBV complications.
Patient & Prescribing Data
People living in British Columbia, including PWID and pregnant women
Pandemic-related disruptions led to sustained reductions in HBV testing, highlighting the need for targeted strategies to restore testing and linkage to care.
Clinical Best Practices
Implement strategies to increase HBV testing post-pandemic, focusing on high-risk populations such as PWID.
by Richard L Morrow, Jean D Makuza, Dahn Jeong, Mike Irvine, Beate Sander, William W L Wong, Yeva Sahakyan, Zoë Greenwald, Hin Hin Ko, Héctor A Velásquez García, Sofia R Bartlett, Jason Wong, Amanda Yu, Mel Krajden, Alnoor Ramji, Ji Hyun Choi, Julia Li, Stanley Wong, Naveed Zafar Janjua
