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CDC recommends hepatitis B testing for all adults.

CDC recommends hepatitis B testing for all adults.

 


March 9, 2023

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The CDC updated its hepatitis B testing guidance for the first time since 2008, and now recommends that every adult in the United States be tested for HBV at least once in their lifetime.

“Chronic hepatitis B virus (HBV) infection can lead to significant morbidity and mortality.” Dr. Erin E. Connors Epidemiologists and colleagues at the CDC’s National Center for HIV, Viral Hepatitis, STDs, and Tuberculosis Control estimate that between 580,000 and 2.4 million people in the United States are infected with HBV, two-thirds of whom are He adds that he may not have been aware of the illness. infection.

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“Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality,” Conners and colleagues wrote.

The authors write that a more universal screening approach would allow for the identification of infections, and those at potential risk of infection, leading to appropriate infection control.

It can also identify people who would benefit from the HBV vaccination recently recommended by the CDC’s Advisory Committee on Immunization. All adults between the ages of 19 and 59.

and MMWR Connors and colleagues conducted a systematic literature review of existing studies and recommendations to assess how universal adult screening for HBV affects the number and composition of screen-positive individuals with HBV infection. provided an update to the CDC’s guidance on HBV testing. May harm HBV screening.

Based on these efforts, updated CDC guidance recommends the following tests:

  • All adults over the age of 18 at least once in their lifetime (new recommendation).
  • All pregnant women during each pregnancy, preferably in the first trimester, regardless of vaccination status or laboratory history.
  • All persons with a history of risk for HBV infection, regardless of age, if they may have been susceptible during the period of risk did not complete the HBV vaccine Series per ACIP recommendations or known vaccine non-responders.
  • Susceptible people with ongoing risk, regardless of age, should be tested regularly while risk persists.
  • Anyone requesting HBV testing, regardless of risk disclosure, “because many may be reluctant to disclose the risk of stigma” (new recommendation);
  • People at high risk for HBV infection, including infant People born to HBsAg-positive pregnant women, people born in areas with HBV prevalence of 2% or more, and people born in the United States whose parents were not vaccinated as infants born in areas with HBV prevalence of 8% or more. , injecting drug users or those with a history, who are currently or previously incarcerated, who have HIV, who have hepatitis C virus or who have had HCV (new recommendations), and who have sex with men men who play

CDC will review and, if necessary, review these recommendations as new treatments, tests, epidemiology, hepatitis B vaccination rates, and experience gained following implementation of these recommendations become available. We plan to revise it.

“Risk-based testing alone fails to identify most people with chronic HBV infection and is ineffectively performed by providers,” the authors wrote. “Along with the vaccination strategy, Adult Universal Screening Appropriate screening of those at high risk for HBV infection will also improve health, reduce HBV infection rates in the United States, and advance the goal of eliminating viral hepatitis. ”

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