Differing profiles of people diagnosed with acute and chronic hepatitis B virus infection in British Columbia, Canada

Table 1 Characteristics of hepatitis B testers in the British Columbia Hepatitis Testers Cohort by hepatitis B diagnosis, 1990-2015 n (%)

	HBV positive			HBV negative
	Acute	Chronic	All positive		P value
	n = 2015	n = 44483	n = 46498	n = 1011558
Sex
Female	590 (29.3)	20094 (45.2)	20684 (44.5)	563440 (55.7)	0.000
Male	1425 (70.7)	24387 (54.8)	25812 (55.5)	448072 (44.3)
Unknown	0 (0.0)	2 (0.0)	2 (0.0)	44 (0.0)
Birth Cohort
< 1945	204 (10.1)	5385 (12.1)	5589 (12.0)	103498 (10.2)	0.000
1945-1964	1001 (49.7)	20316 (45.7)	21317 (45.8)	297768 (29.4)
1965-1974	577 (28.6)	9852 (22.1)	10429 (22.4)	199121 (19.7)
> 1974	233 (11.6)	8930 (20.1)	9163 (19.7)	411171 (40.6)
Age group at HBV diagnosis (yr)
< 25	306 (15.2)	5163 (11.6)	5469 (11.8)	137379 (13.6)	0.000
25-34	653 (32.4)	9963 (22.4)	10616 (22.8)	264809 (26.2)
35-44	552 (27.4)	11835 (26.6)	12387 (26.6)	220745 (21.8)
45-54	317 (15.7)	9202 (20.7)	9519 (20.5)	165884 (16.4)
55-64	115 (5.7)	4954 (11.1)	5069 (10.9)	117550 (11.6)
> 64	72 (3.6)	3366 (7.6)	3438 (7.4)	105191 (10.4)
Median [IQR]	35 [28-45]	41 [31-51]	40 [31-50]	39 [29-53]	0.000
Year of HBV diagnosis
1990-1999	1388 (68.9)	14068 (31.6)	15456 (33.2)	47343 (4.7)	0.000
2000-2004	362 (18.0)	11246 (25.3)	11608 (25.0)	126715 (12.5)
2005-2009	196 (9.7)	8968 (20.2)	9164 (19.7)	219195 (21.7)
2010-2015	69 (3.4)	10201 (22.9)	10270 (22.1)	618305 (61.1)
Ethnicity
East Asian	278 (13.8)	26578 (59.7)	26856 (57.8)	139306 (13.8)	0.000
Other	35 (1.7)	1651 (3.7)	1686 (3.6)	41452 (4.1)
South Asian	125 (6.2)	1420 (3.2)	1545 (3.3)	83200 (8.2)
White	1577 (78.3)	14834 (33.3)	16411 (35.3)	747600 (73.9)
HCV
Negative	1296 (64.3)	39575 (89.0)	40871 (87.9)	964780 (95.4)	0.000
Positive	719 (35.7)	4908 (11.0)	5627 (12.1)	46778 (4.6)
HIV
Negative	1888 (93.7)	43370 (97.5)	45258 (97.3)	1006511 (99.5)	0.000
Positive	127 (6.3)	1113 (2.5)	1240 (2.7)	5047 (0.5)
HCV and HIV
Positive	82 (4.1)	712 (1.6)	794 (1.7)	1768 (0.2)	0.000
Active tuberculosis
Negative	2004 (99.5)	44101 (99.1)	46105 (99.2)	1008555 (99.7)	0.000
Positive	11 (0.5)	382 (0.9)	393 (0.8)	3003 (0.3)
Problematic alcohol use
No	1807 (89.7)	42544 (95.6)	44531 (95.8)	959326 (94.8)	0.000
Yes	208 (10.3)	1939 (4.4)	2147 (4.6)	52232 (5.2)
Illicit drug use
No	1617 (80.2)	41558 (93.4)	43175 (92.9)	944910 (93.4)	0.000
Yes	398 (19.8)	2925 (6.6)	3323 (7.1)	66648 (6.6)
Injection drug use
No	1718 (85.3)	42040 (94.5)	43758 (94.1)	960849 (95.0)	0.000
Yes	297 (14.7)	2443 (5.5)	2740 (5.9)	50709 (5.0)
Major mental illness
No	1788 (88.7)	41410 (93.1)	43198 (92.9)	874387 (86.4)	0.000
Yes	227 (11.3)	3073 (6.9)	3300 (7.1)	137171 (13.6)
Material deprivation quintile
Q1 (most privileged)	320 (15.9)	7076 (15.9)	7396 (15.9)	228694 (22.6)	0.000
Q2	303 (15.0)	6753 (15.2)	7056 (15.2)	189225 (18.7)
Q3	320 (15.9)	7797 (17.5)	8117 (17.5)	189823 (18.8)
Q4	425 (21.1)	9564 (21.5)	9989 (21.5)	198263 (19.6)
Q5 (most deprived)	585 (29.0)	12226 (27.5)	12811 (27.6)	185193 (18.3)
Unknown	62 (3.1)	1067 (2.4)	1129 (2.4)	20360 (2.0)
Social deprivation quintile
Q1 (most privileged)	247 (12.3)	9952 (22.4)	10199 (21.9)	184233 (18.2)	0.000
Q2	267 (13.3)	9032 (20.3)	9299 (20.0)	180059 (17.8)
Q3	314 (15.6)	7574 (17.0)	7888 (17.0)	173461 (17.1)
Q4	383 (19.0)	7336 (16.5)	7719 (16.6)	199229 (19.7)
Q5 (most deprived)	742 (36.8)	9522 (21.4)	10264 (22.1)	254216 (25.1)
Unknown	62 (3.1)	1067 (2.4)	1129 (2.4)	20360 (2.0)

Data collected at baseline (date of diagnosis for HBV positive or last negative test for HBV negative) unless otherwise indicated. HIV: Human immunodeficiency virus; HCV: Hepatitis C virus; HBV: Hepatitis B virus; IDU: Injection drug use; OST: Opioid substitution therapy; Q: Quintile.

Table 2 Multivariable multinomial regression model for factors associated with acute or chronic hepatitis B virus in the British Columbia Hepatitis Testers Cohort, 1990-2015

	Adjusted OR (95%CI)
	Acute HBV	Chronic HBV
Sex
Male	2.28 (2.06-2.52)	1.43 (1.40-1.46)
Female	1.00	1.00
Age at HBV diagnosis (yr)
< 25	2.38 (1.97-2.87)	0.89 (0.85-0.92)
25-34	2.62 (2.21-3.09)	1.09 (1.05-1.13)
35-44	1.82 (1.53-2.16)	1.19 (1.15-1.23)
45-54	1.49 (1.23-1.79)	1.22 (1.18-1.27)
55 +	1.00	1.00
Ethnicity
East Asian	1.76 (1.53-2.02)	12.45 (12.15-12.77)
Other	0.88 (0.63-1.24)	3.06 (2.90-3.23)
South Asian	1.66 (1.37-2.02)	1.26 (1.19-1.33)
White	1.00	1.00
HCV
Positive	5.23 (4.65-5.87)	2.89 (2.77-3.01)
Negative	1.00	1.00
HIV
Positive	5.29 (4.30-6.51)	5.73 (5.29-6.20)
Negative	1.00	1.00
Active tuberculosis
Yes	0.59 (0.32-1.09)	0.97 (0.85-1.10)
No	1.00	1.00
Problematic alcohol use
Yes	0.87 (0.74-1.04)	1.02 (0.96-1.08)
No	1.00	1.00
Injection drug use
Yes	1.84 (1.57-2.17)	1.67 (1.58-1.77)
No	1.00	1.00
Major mental illness
Yes	0.73 (0.62-0.85)	0.74 (0.71-0.78)
No	1.00	1.00
Material deprivation quintile
Q1 (most privileged)	1.00	1.00
Q2-4	1.06 (0.94 -1.21)	1.10 (1.06-1.13)
Q5 (most deprived)	1.35 (1.17 -1.55)	1.35 (1.30-1.39)
Social deprivation quintile
Q1 (most privileged)	1.00	1.00
Q2-4	1.20 (1.04-1.39)	0.97 (0.95-1.00)
Q5 (most deprived)	1.56 (1.34-1.82)	1.00 (0.97-1.03)
Year of HBV diagnosis
1990-1999	1.00	1.00
2000-2004	0.10 (0.09-0.12)	0.27 (0.26-0.28)
2005-2009	0.03 (0.03-0.04)	0.14 (0.13-0.14)
2010-2015	0.00 (0.00-0.01)	0.05 (0.05-0.06)

HIV: Human immunodeficiency virus; HCV: Hepatitis C virus; HBV: Hepatitis B virus; Q: Quintile.

Table 3 Multivariable multinomial regression model (with interaction terms) for factors associated with acute or chronic hepatitis B virus in the British Columbia Hepatitis Testers Cohort, 1990-2015

	Adjusted OR (95% CI)
	Acute HBV	Chronic HBV
Sex
Male	2.30 (2.08-2.54)	1.43 (1.4-1.46)
Female	1.00	1.00
HCV
Positive	5.22 (4.65-5.86)	2.88 (2.77-3.00)
Negative	1.00	1.00
HIV
Positive	5.25 (4.26-6.47)	5.75 (5.31-6.22)
Negative	1.00	1.00
Active tuberculosis
Yes	0.58 (0.31-1.08)	0.97 (0.86-1.10)
No	1.00	1.00
Problematic alcohol use
Yes	0.90 (0.75-1.07)	1.01 (0.95-1.07)
No	1.00	1.00
Major mental illness
Yes	0.72 (0.61-0.84)	0.75 (0.71-0.78)
No	1.00	1.00
Social deprivation quintile
Q2-Q4	1.21 (1.05-1.40)	0.97 (0.94-1.00)
Q5 (most deprived)	1.58 (1.36-1.84)	0.99 (0.96-1.03)
Q1 (most privileged)	1.00	1.00
IDU*Age at HBV diagnosis (yr)
IDU* < 25	7.55 (5.13-11.10)	1.43 (1.18-1.73)
IDU*25-34	5.32 (4.08-6.94)	1.72 (1.55-1.91)
IDU*35-44	2.98 (2.26-3.93)	1.87 (1.71-2.05)
IDU*45-54	1.77 (1.19-2.62)	2.06 (1.87-2.28)
IDU*55+	1.56 (0.78-3.10)	2.34 (2.05-2.65)
No IDU* < 25	2.23 (1.84-2.71)	0.90 (0.86-0.93)
No IDU*25-34	2.53 (2.13-3.01)	1.11 (1.07-1.15)
No IDU*35-44	1.84 (1.54-2.19)	1.21 (1.17-1.25)
No IDU*45-54	1.57 (1.30-1.90)	1.24 (1.20-1.28)
No IDU*55+	1.00	1.00
Ethnicity*Material Deprivation quintile
East Asian*Material deprivation Q2-Q4	1.71 (1.37-2.12)	13.39 (12.82-13.98)
East Asian*Material deprivation Q5	2.61 (2.06-3.32)	15.98 (15.23-16.77)
East Asian*Material deprivation Q1	2.05 (1.49-2.81)	11.69 (11.07-12.33)
Other*Material deprivation Q2-Q4	0.97 (0.60-1.57)	3.32 (3.07-3.60)
Other*Material deprivation Q5	1.15 (0.59-2.26)	4.23 (3.78-4.74)
Other*Material deprivation Q1	0.89 (0.44-1.81)	2.62 (2.32-2.95)
South Asian*Material deprivation Q2-Q4	1.81 (1.35-2.42)	1.42 (1.30-1.54)
South Asian*Material deprivation Q5	2.44 (1.81-3.30)	1.41 (1.28-1.56)
South Asian*Material deprivation Q1	1.02 (0.48-2.19)	1.55 (1.32-1.82)
White*Material deprivation Q2-Q4	1.08 (0.94-1.25)	1.03 (0.98-1.08)
White*Material deprivation Q5	1.33 (1.13-1.56)	1.36 (1.29-1.43)
White*Material deprivation Q1	1.00	1.00
Year of HBV diagnosis
1990-1999	1.00	1.00
2000-2004	0.10 (0.09-0.12)	0.27 (0.26-0.28)
2005-2009	0.03 (0.03-0.04)	0.14 (0.13-0.14)
2010-2015	0.00 (0.00-0.01)	0.05 (0.05-0.06)

IDU: Injection drug use; HIV: Human immunodeficiency virus; HCV: Hepatitis C virus; HBV: Hepatitis B virus; Q: Quintile.