Study Population

The study population was made up of individuals enrolled in the BC-CfE HIV PrEP program from January 2018 to June 2019 and followed until 31 August 2019. To access PrEP, health care providers were required to document HBV status (HBV surface antigen [HBsAg] status as positive or negative) during the enrollment process. The BC-CfE PrEP program has ongoing linkage with data obtained from the St Paul’s Hospital/Providence Health Care laboratory interface in Vancouver, BC. Of note, the St Paul’s Virology Laboratory performs all HBV DNA monitoring for the province.

We evaluated the prevalence of HBV defined based on physician report as indicated on a PrEP Enrollment and Prescription Request Form or documented baseline HBsAg in the St Paul’s Virology Laboratory system. Individuals with an isolated HBV core antibody were therefore not included. Baseline was defined as any available result 6 months prior to 3 months following PrEP initiation. We compared baseline demographic characteristics including median age, gender, PrEP-qualifying risk factors, and urban vs rural location (based on 3-digit postal code) between those with and those without HBV, using χ², Fisher exact, or Kruskal-Wallis tests. We assessed the proportion of HBV-positive individuals who underwent evaluation of HBV DNA status at baseline and at any time over the follow-up period, as a measure for engagement in HBV care.