Medpage Today reported that the US Preventive Services Task Force (USPSTF) has recommended hepatitis B virus (HBV) testing for individuals at high risk of contracting the disease. This recommendation represents a change from USPSTF’s 2004 position against screening and an expansion of its 2009 position that recommended prenatal screening for pregnant women only. The present focus is on asymptomatic, nonpregnant adolescents and adults who fall into high-risk categories. Health experts welcome the upgraded recommendations and say they are long overdue. CDC, the American Association for the Study of Liver Diseases, and the Institute of Medicine have recommended testing of high-risk groups for some time.
USPSTF detailed the high-risk categories to be: persons born in countries where the prevalence of HBV infection is 2 percent or higher; US-born citizens who were not vaccinated in infancy, but whose parents were from a high HBV prevalence country; persons with HIV; injection drug users; people living in the same household with people who have HBV; and men who have sex with men.
USPSTF noted that between 700,000 and 2.2 million Americans have chronic HBV and estimates that between 15 and 25 percent of those people will die from cirrhosis or liver cancer. Those with chronic HBV also can transmit the disease to others, and screening will help people make treatment choices or other prevention choices. New HBV treatment therapies now exist and recent research indicates that immunoprophylaxis given to HBV-positive pregnant women can prevent vertical transmission of the disease to the newborn.
The full report, “Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults: U.S. Preventive Services Task Force Recommendation Statement,” was published online in the Annals of Internal Medicine (2014; doi: 10.7326/M14-1018).
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