Adults should be tested for hepatitis B virus (HBV) at least once in their lifetime, according to updated guidelines from the Centers for Disease Control and Prevention (CDC).
This is the first update to HBV screening guidelines since 2008, the agency said.
“Risk-based testing alone has not identified the majority of people living with chronic HBV infection and is considered inefficient for providers to implement,” the authors write in the new guidance, published in the journal from the CDC. Weekly Morbidity and Mortality Report. “Universal screening for HBV infection in adults is cost-effective compared to risk-based screening and prevents liver disease and death. Although no curative treatment is yet available, early diagnosis and treatment of chronic infections by HBV reduce the risk of cirrhosis and liver cancer. , and die.”
An estimated 580,000 to 2.4 million people are living with HBV infection in the United States, and two-thirds may not know they are infected, the agency said.
The virus is spread through contact with blood, semen, and other bodily fluids from an infected person.
The guideline now recommends using the triple panel (HBsAg, anti-HBs, total anti-HBc) for initial screening.
“It can help identify people who have active HBV infection and could be linked to care; they have [a] has resolved the infection and may be susceptible to reactivation (eg, immunosuppressed individuals); are susceptible and need vaccination; or are vaccinated,” the authors write.
Ideally, pregnant women should be screened in the first trimester of each pregnancy, regardless of vaccination status or testing history. Pregnant people who have already had timely triple screening for hepatitis B and who have no new HBV exposures need only HBsAg screening, according to the guidelines.
The document added three groups at increased risk of HBV infection: those who are incarcerated or previously incarcerated, people with current or past infection with the hepatitis C virus, and people with current or past sexually transmitted infections and multiple sexual partners. People at increased risk for HBV should be screened regularly, based on shared decision-making between provider and patient, as well as individual risk and immune status.
Additional research is needed on the optimal frequency of periodic testing, the authors say.
“In conjunction with vaccination strategies, universal adult screening and appropriate testing of persons at increased risk for HBV infection will improve health outcomes, reduce the prevalence of HBV infection in the United States, and advance elimination goals.” of viral hepatitis,” the authors write.
MMWR Recommended Representative. Posted on March 10, 2023. Text complete
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