Hepatitis B screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
High-risk groups should be tested for HBV infection. These include immigrants/refugees from areas of intermediate or high endemicity, persons with chronically elevated aminotransferases, immunocompromised individuals, and persons with a history of injection drug use(IDU).[1] Additionally, screening for hepatocellular carcinoma should extend to any HBV carrier over 40 years with persistent or intermittent ALT elevation and/or high HBV DNA level >2,000 IU/mL.[2]
Screening
Recommendations for Persons Who Should Be Screened for HBV Infection
The following groups should be tested for HBV infection:[1]
- Persons born in high or intermediate endemic areas
- United States–born people who were not vaccinated as infants and whose parents were born in regions with high HBV endemicity
- Persons with chronically elevated aminotransferases
- Persons who require immunosuppressive therapy
- Men who have sex with men
- People with multiple sexual partners or history of sexually transmitted disease
- Incarcerated people
- Persons who have ever used injecting drugs, dialysis patients, HIV- or HCV-infected individuals, pregnant women, and family members, household members, and sexual contacts of HBV-infected people
- Testing for HBsAg and anti-HBs should be performed, and seronegative persons should be vaccinated. (Grade I Recommendation)
Group | Screening Recommendations |
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Pregnant women |
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Asymptomatic/Nonpregnant adolescents and adults at high risk (HBV) |
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Recommendations for HCC Screening: AASLD Practice Guidelines
The following groups should be screened with US examination every 6-12 months: (Grade II-2)[2]
- HBV carriers at high risk for HCC such as Asian men over 40 years and Asian women over 50 years of age
- People with cirrhosis
- People with a family history of HCC
- Individuals of African descent over 20 years of age
- Any carrier over 40 years with persistent or intermittent ALT elevation and/or high HBV DNA level >2,000 IU/mL
For HBV carriers at high risk for HCC who are living in areas where US is not readily available, periodic screening with AFP should be considered. (Grade II-2)
References
- ↑ 1.0 1.1 U.S Preventive Services Task Force. Hepatitis B. (2016) https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=hepatitis+b Accessed on October 10th, 2016
- ↑ 2.0 2.1 AASLD guidelines for treatment of chronic hepatitis B. Hepatology (2016) http://onlinelibrary.wiley.com/doi/10.1002/hep.28156/full Accessed on October 10th, 2016