This survey, by the ICE-HBV POC working group, is part of an international collaborative research review project on HBV management in resource-limited settings (RLS). The main objective of the project is to improve access to/quality of HBV care in RLS and reduce HBV mortality and incidence.

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* 1. Your age

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* 2. Your gender

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* 3. Where do you work (region)? Please select all apply and specify country/countries under Other.

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* 4. Your professional role on HBV (elaborate on "other" field)

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* 5. Increased HBV screening and diagnosis is important to achieve the WHO 2030 goal for HBV [Please rank in a 5-point scale: 1 being the highest priority, 5 being the lowest]

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* 6. Increased access to antiviral therapy is important to achieve the WHO 2030 goal for HBV [Please rank in a 5-point scale: 1 being the highest priority, 5 being the lowest]

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* 7. Increased rate of liver cancer surveillance is important to achieve the WHO 2030 goal for HBV [Please rank in a 5-point scale: 1 being the highest priority, 5 being the lowest]

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* 8. Optimize strategies to prevent mother-to-child-transmission (MTCT) of HBV is important to achieve the WHO 2030 goal for HBV [Please rank in a 5-point scale: 1 being the highest priority, 5 being the lowest]

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* 9. Optimize strategies to monitor HBV disease progression is important to achieve the WHO 2030 goal for HBV [Please rank in a 5-point scale: 1 being the highest priority, 5 being the lowest]

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* 10. Please indicate which of the following tests/technology are available in your location (Check all that apply).

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* 11. Should only WHO pre-qualified HBsAg rapid diagnostic tests be used for screening?

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* 12. HBsAg positive rapid test result needs to be confirmed by standard HBsAg ELISA test before the participant undergoes further HBV evaluation?

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* 13. Is anti-HDV screening routinely performed on HBsAg (+) patients in your location? 

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* 14. If HBV DNA is in the treatment algorithm, an affordable POC HBV DNA test is necessary to deliver HBV care in my location

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* 15. POC ALT, AST tests would be of value to deliver HBV care in my location

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* 16. Are laboratories within reach to process dry blood spot (DBS) samples for HBV DNA (PCR assay) and other fibrosis, liver cancer biomarkers?

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* 17. Transient Elastography (Fibroscan) is an important tool for liver fibrosis determination (1 being most important, 5 least important)

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* 18. APR-1 (needs AST, platelet to calculate) is an important tool for liver fibrosis determination (1 being most important, 5 least important)

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* 19. Fib-4 (needs age, AST, ALT platelet to calculate) is an important tool for liver fibrosis determination (1 being most important, 5 least important)

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* 20. Validated novel fibrosis marker (collect DBS samples locally and perform assays in designated labs) is an important tool for liver fibrosis determination (1 being most important, 5 least important)

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* 21. Which modality for fibrosis determination is available in your location? (Check none or all applied)

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* 22. AFP is an important modality for liver cancer surveillance (1 being most important, 5 least important)

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* 23. Abdominal ultrasound  is an important modality for liver cancer surveillance (1 being most important, 5 least important)

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* 24. Abdominal ultrasound + AFP  is an important modality for liver cancer surveillance (1 being most important, 5 least important)

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* 25. Abdominal CT scan  is an important modality for liver cancer surveillance (1 being most important, 5 least important)

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* 26. Abdominal MRI  is an important modality for liver cancer surveillance (1 being most important, 5 least important)

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* 27. Validated novel biomarkers (collect DBS locally and perform tests in designated laboratories) are important modalities for liver cancer surveillance (1 being most important, 5 least important)

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* 28. Which liver cancer surveillance modality is being applied in your location (check none or all applied)

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* 29. Please indicate which of the following HBV medication(s) are available in your location (check none or all applied)

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* 30. How do you monitor medication compliance? (Check all applied)

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* 31. At your location, are children (<18 years) with chronic hepatitis B offered antiviral therapy?

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* 32. At your location, please indicate the approximate  makeup biological gender of the adult HBV populations being evaluated (must add up to 100% - do not include % symbol in answer)

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* 33. In your location, please indicate the age composition of the adult HBV populations being evaluated (must add up to 100% - do not include % in answer)

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* 34. Chronic hepatitis B patients with advanced hepatic fibrosis (stage 3 or 4) should have top priority in receiving antiviral therapy. [Can skip question if you are unsure]

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* 35. Chronic hepatitis B patients with elevated ALT (regardless of HBV DNA Level) in the absence of other liver conditions (i.e. hepatitis C, fatty liver) should have priority in receiving antiviral therapy. [Can skip question if you are unsure]

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* 36. Hepatitis B infected patients with HBeAg (+) and normal ALT should be routinely treated with antiviral therapy. [can skip question if you are unsure]

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* 37. HBsAg(+) patients over 40 years of age should be routinely treated with antiviral therapy regardless of their HBV DNA, HBeAg and ALT status. [can skip question if you are unsure]

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* 38. All HBsAg(+) adult patients should be routinely treated with antiviral therapy regardless of their HBV DNA, HBeAg and ALT status. [can skip question if you are unsure]

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* 39. At your location, who can provide antiviral treatment for hepatitis B? (Check all that apply)

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* 40. At your location, are adequate tiered training and resources available to the health providers for hepatitis B management?

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* 41. At your location, can HBV counseling and evaluation be done in a stigma and discrimination free environment with confidentiality?

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* 42. Should HBV diagnosis and treatment be integrated into the HIV care infrastructure if there is already one in place? 

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* 43. Is universal screening of pregnant women for HBV at antenatal visit in place at your location?

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* 44. What is the major barrier to screening pregnant women for HBV at your location?

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* 45. Do you need support to ensure birth dose vaccination is universally provided?

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* 46. In your location, what do the babies born to HBsAg mother receive to prevent MTCT of HBV?

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* 47. At your location, are pregnant women with high level of viremia (HBV DNA >200,000 IU/ml) offered antiviral therapy during the third trimester to further prevent MTCT of HBV?

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* 48. If the answer to Q47 is no, please provide reason (check all applied or comment)

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* 49. If only HBeAg but not HBV DNA testing is available in your care setting, are you willing to use HBeAg positivity as a surrogate marker for high viremia and provide pregnant women with antiviral therapy to prevent MTCT of HBV? 

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* 50. POC HBeAg test would be of value to deliver HBV care in my location

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* 51. Do babies born to mothers with hepatitis B have routine HBsAg check at or after 7 months of age at your location? 

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* 52. Do babies born to mother with hepatitis B have routine anti-HBs check at or after 7 months of age at your location? 

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* 53. Country/ regional specific HBV management guidelines should be developed to achieve the 2030 WHO goal for HBV.

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