Impact of a nurse-led enhanced monitoring, management and contact tracing intervention for chronic hepatitis B in England, 2015-2017

Kazim Beebeejaun, Zahin Amin-Chowdhury, Louise Letley, Edna Kara, Beauty Mahange, Kate Harrington, Jacqui Checkley, Sultan Salimee, Kristina Poole, Samreen Ijaz, Graeme Alexander, Mary Ramsay, Sema Mandal, Michael Edelstein

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Around 200,000 people live with chronic hepatitis B in England. Despite national guidance on identification and management of cases and their close contacts, testing rates of close contacts is as low as 43% in high prevalence areas of London. Our study aimed to determine whether a nurse-led enhanced management and contact tracing of chronically infected individuals improved testing uptake, vaccination and onward referral of close contacts. The study was conducted across Greater Manchester and East of England regions between October 2015 and July 2017. All HBV chronically infected individuals registered with a GP and their close contacts were eligible for recruitment. The proportion of contacts who were tested, vaccinated and referred where appropriate were compared before and after the nurse-led intervention. Baseline and outcome information was collected using questionnaires. The intervention improved case referral rates by an additional 14% (from 86% (88/102 cases) to 99.7%; 648/650 cases). The proportion of contacts tested increased from 34% to 72%-94% with 18 new cases of HBV diagnosed. Amongst close contacts tested, vaccination rates of at least three doses increased from 77% (43/56) to 93% (452/491) during the study. Our study has shown that nurse-led enhanced management greatly improves identification, testing and vaccination of close contacts. The identification of new acute and chronic cases is likely to make the intervention cost effective and local health commissioners should consider providing a nurse-led service as part of hepatitis B care pathways.

Original languageEnglish
Pages (from-to)72-79
Number of pages8
JournalJournal of Viral Hepatitis
Issue number1
StatePublished - Jan 2021
Externally publishedYes

Bibliographical note

Funding Information:
This study was part of the EMPACT‐B project (Enhanced management and contract tracing among antenatally screened HBV‐infected women and chronically infected individual to improve testing uptake, vaccination and onward referral of household contacts) funded through a NIHR grant (project 015/310).

Publisher Copyright:
© 2020 Crown copyright. Journal of Viral Hepatitis published by John Wiley & Sons Ltd. This article is published with the permission of the Controller of HMSO and the Queen’s Printer for Scotland.


  • hepatitis b
  • immunization


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