By Jonathan Springston, Editor, Relias Media
The U.S. Preventive Services Task Force (USPSTF) calls on clinicians to screen teens and adults who are not pregnant and are at high risk for hepatitis B, a recommendation the agency gave a grade B.
USPSTF defines high risk as people born in countries or regions with a high prevalence of hepatitis B infection (regardless of vaccine history), those born in the United States who were not vaccinated as babies, IV drug users, HIV-positive patients, men who have sex with men, and people who are in close contact with a person who is hepatitis B-positive.
“The new recommendations reinforce and strengthen the 2014 guidelines, citing additional data that show the clinical benefits of antiviral therapy in decreasing mortality rates, as well as the risk of developing liver cancer,” Anna Lok, MD, assistant dean for clinical research and director of clinical hepatology at Michigan Medicine, said in a statement. “The guidelines rendered a ‘grade B’ recommendation, which ensures that insurance companies will continue to cover [hepatitis B] screenings without a required copay for persons at increased risk.” (Lok also authored an editorial that accompanied the recommendations in which she explained the guidelines in more detail).
Meanwhile, the Hepatitis B Foundation said it is “very disappointed” that USPSTF recommended a risk-based screening approach. The foundation estimates 2 million Americans live with hepatitis B, but between 65% and 75% are undiagnosed. (Federal estimates put this number anywhere between 730,000 and 2.2 million, depending on the source.)
“It is time to transition to universal testing of all adults for HBV [hepatitis B] infection. Adequate screening means not only with the hepatitis B surface antigen test, as recommended by USPSTF, but with the complete panel of hepatitis B tests — surface antigen, surface antibody, and core antibody. Screening with hepatitis B surface antigen alone represents a missed opportunity to identify individuals who need to be vaccinated, as well as those who are at risk of reactivation of their HBV infection,” Chari Cohen, DrPH, MPH, senior vice president of the Hepatitis B Foundation, said in a statement. “A universal adult hepatitis B screening strategy will help identify infected individuals and link them with care to reduce deaths due to hepatitis B, vaccinate and provide lifelong protection for susceptible individuals, decrease stigma and discrimination associated with an infectious disease, and eliminate hepatitis B in future generations.”