Golasa Samadi Kochaksaraei is an MD currently pursuing a Ph.D. in the Gastrointestinal Sciences program, specializing in epidemiology. The main focus of her research for her thesis is the burden of Chronic Hepatitis B in Alberta.

Title: Epidemiology, Linkage to Care and Natural History of Women of Childbearing Age with Chronic Hepatitis B: A Population-based Study. Background: The natural history of chronic hepatitis B (CHB) is affected by many factors including vaccination, immigration, and risk of vertical transmission. Purpose: To study the epidemiology of CHB among women of childbearing age (WoCBA, 18-49 years) in Alberta, Canada. Methods: We retrospectively analyzed Alberta Analytics databases to study CHB epidemiology, natural history, and care linkage among WoCBA in Alberta, between April 2012-March 2021. A Poisson regression was conducted to estimate incidence and prevalence trends, whereas predictors of care linkage were determined using logistic regression. Results: Age/sex-adjusted CHB incidence among WoCBA between 2015-2020 was 36.2/100,000 person/years, highest among individuals aged 30-39 years. CHB incidence decreased from 52.6 to 18.2/100,000 between 2015-2020, but prevalence increased from 131.7 to 248.6/100,000 in the same period. Incident CHB cases (n=2,124) had lower survival rates than age/sex-matched Canadians, with a standardized mortality ratio of 5.7 (95% CI 2.6-11.0). Increasing age (years) at diagnosis (HR, 1.2; 95% CI 1.1-1.3), and hepatocellular carcinoma (HR, 19.8; 95% CI 3.9-102.1) were independently associated with mortality. Receiving anti-HBV treatment and year of diagnosis were not significantly associated with mortality. Of the 1,927 women with 2,436 hepatitis B surface antigen-positive pregnancies from 2012 to 2020, only 27.6% had recommended HBV assessment during pregnancy. Of those women meeting criteria for antiviral therapy to prevent mother-to-child transmission (MTCT), only 66.4% received treatment. Conclusions: Suboptimal management during pregnancy and overall lower survival rates highlight the need to address care linkage barriers in women of childbearing age living with CHB.