Prevalence of anti-hepatitis B core in men who have sex with men attending a sexual health clinic in Brighton, UK, from 2012 to 2019

Abstract

Objective Hepatitis B is sexually transmitted among men who have sex with men (MSM) and has previously been endemic in some populations of MSM. Presence of anti-hepatitis B core (anti-HBc) determines previous or ongoing infection. We aimed to establish the prevalence and associations of anti-HBc in our clinic population of MSM. Method A cross-sectional study of newly attending MSM to determine the prevalence and associations of testing positive for anti-HBc using our clinic database from 2012 to 2019. We used crude odds ratios to identify any associations. Results There were 3342/5842 (58%) newly attending MSM who were tested for anti-HBc between 2012 and 2019. Of the 3342 MSM tested for anti-HBc, the median age was 30 years (interquartile range 23–43), 442 (13%) were living with HIV, 10 (0.3%) were HBsAg positive, 62 (1.9%) had past/current hepatitis C, 401 (12%) had a positive syphilis enzyme immunoassay (EIA), 455 (14%) were diagnosed with either gonorrhoea or chlamydia and 1080 (32%) were non-UK born. A total of 331 (10%, 95% confidence interval (CI) = 8.9–11.0) tested positive for anti-HBc and the proportion testing positive reduced significantly throughout the study period (P < 0.004). Testing positive for anti-HBc was associated with age >30 years (OR = 8.2, 95% CI = 5.9–11.4, P < 0.0001), having past/current hepatitis C (odds ratio (OR) = 5.0, 95% CI = 3.0–8.6, P < 0.0001), having a positive syphilis EIA (OR = 5.9, 95% CI = 4.4–7.3, P < 0.0001) and being non-UK born (OR = 1.4, 95% CI = 1.1–1.8, P < 0.006). There were no associations with HIV status or having a diagnosis of gonorrhoea or chlamydia. Conclusion Although reducing, the prevalence of anti-HBc remains endemic in MSM locally and further efforts are needed to enhance hepatitis B prevention strategies.