Screen high risk people for hepatitis B: USPSTF

By Megan Brooks

NEW YORK (Reuters Health) - The U.S. Preventive Services Task Force (USPSTF) has issued updated recommendations on screening for hepatitis B virus (HBV) infection.

After reviewing the latest evidence, the Task Force now recommends screening people who have the following risk factors for HBV infection:

* People born in countries and regions with a high prevalence of HBV infection, such as Africa, Southeast Asia, Pacific Islands, China, Middle East, Eastern Europe, and the northern countries in South America.

* U. S.-born persons not vaccinated as infants whose parents were born in countries or regions with a high prevalence of HBV infection.

* HIV-positive people, injection drug users, men who have sex with men, and those living with or having sex with someone with HBV infection.

* Patients with weakened immune systems or undergoing treatment for kidney failure (hemodialysis).

What's changed since the 2004 USPSTF recommendation on hepatitis B screening?

Task force member Dr. Douglas K. Owens, professor of medicine and of health research and policy at Stanford University in California, explained, "In 2004, the USPSTF recommended against screening in the general population for chronic HBV infection (D Recommendation). An accurate screening test, advances in treatment and health outcomes, and effective antiviral therapies with small harms led the Task Force to update its recommendation and recommend HBV infection screening for high-risk individuals (B recommendation)."

"The main difference between the 2004 and this new recommendation is that this recommendation does not include a recommendation for the general population, and instead focuses on high-risk populations. The prevalence of HBV infection is low in the general U.S. population," Dr. Owens said by email.

Up to 2.2 million people in the U.S. are chronically infected with hepatitis B and 15% to 25% of those people die from liver disease or liver cancer, the task force notes in a statement.

"Screening can identify people who have chronic HBV infection, and the good news is that treatment can help prevent liver cancer in these people," Dr. Owens said.

The USPSTF, he added, "aims to keep all recommendations current and review each topic every five years. The Task Force is involved in the development of recommendations for a significant number of topics, and occasionally urgent topics (such as those that pose a greater risk to public health) emerge and must be prioritized. Some recommendations also take longer than others to develop and finalize for several reasons, such as the scope and complexity of the issue, the time needed for additional consideration of public and partner feedback, or other external factors such as the publication schedules of journals."

The updated recommendation on hepatitis B screening is available online now in the Annals of Internal Medicine and on the USPSTF web site at: www.uspreventiveservicestaskforce.org.

SOURCE: http://bit.ly/1iwcCpe

Ann Intern Med 2014.