OC87 Transition of young people with chronic hepatitis B from a paediatric liver centre to adult health services

Le résumé fourni par la source

Young people (YP) are more likely to engage and be retained if successfully linked to Adult Health Services (AHS) during the transitioning process. The aim of this study was to determine the incidence of YP with chronic Hepatitis B (CHB) successfully transitioning from a specialist paediatric viral hepatitis care to AHS and to identify any barriers that may contribute in non-linkage to AHS. This is a retrospective study of YP followed up at a specialist paediatric liver centre in the United Kingdom who were transitioned to AHS. The study period was between 2018–2023 and includes the 2020–2021 lock down period due to SARS-CoV- 2 pandemic. Non linkage to AHS was defined as nonattendance of at least one of the two initial outpatient appointments in AHS after transitioning. Demographics, mode of transmission, ethnicity, follow up in paediatric and adult services, antiviral treatment, first degree family member with CHB, virtual or in person consultation at transition, comorbidities, was obtained from electronic data base at paediatric and AHS sites. Seventy YP were transitioned to AHS during the study period. Of these, 35 (50%) were transitioned during the lock down period. The mode of transmission was vertical in 44, horizontal in 4 and not known in 22. Majority were Asians (n=42, 60%). None of the patients were lost to follow up during paediatric follow up. Of the 37 and 31 YP who were offered in person and Virtual transition appointments respectively at the paediatric centre, 23 attended in each group. 23 patients had received antivirals for CHB either as part of research study or for clinical reasons. 13 patients were on antivirals (Entecavir or Tenofovir) at time of transition. Sixty-one YP (87%) were successfully linked to AHS while 9 did not attend AHS and were lost to follow up. 16 YP had co morbidities (other medical illness needing medical follow up) and all were linked to viral hepatitis services in AHS, see table 1. Of the 9 patients not linked to AHS, a referral to AHS was lost in the system, one YP was asylum seeker, one had high nonattendance in paediatric services, two had moved out of area and not contactable and no cause could be identified in the remaining four. The dedicated paediatric viral hepatitis service contributed to high rates of successful linkage to AHS. Of the 9 YP not linked to AHS, 7 transitioned during the lock down and may have contributed to non-linkage of care.

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