Hepatitis B screening: Difference between revisions
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==Overview== | ==Overview== | ||
High-risk groups should be tested for [[HBV]] infection. These include immigrants/refugees from areas of intermediate or high [[endemic|endemicity]], persons with chronically elevated [[aminotransferases]], [[immunocompromised]] individuals, and persons with a history of injection drug use([[IDU]]).<ref name=USPTF-HepatitsB>U.S Preventive Services Task Force. Hepatitis B. (2016) https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=hepatitis+b Accessed on October 10th, 2016</ref> | High-risk groups should be tested for [[HBV]] infection. These include immigrants/refugees from areas of intermediate or high [[endemic|endemicity]], persons with chronically elevated [[aminotransferases]], [[immunocompromised]] individuals, and persons with a history of injection drug use([[IDU]]).<ref name="USPTF-HepatitsB">U.S Preventive Services Task Force. Hepatitis B. (2016) https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=hepatitis+b Accessed on October 10th, 2016</ref> | ||
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.<ref name=Hepatology> 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</ref> | 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.<ref name="Hepatology">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</ref> | ||
==Screening== | ==Screening== | ||
===Recommendations for Persons Who Should Be Screened for HBV Infection=== | ===Recommendations for Persons Who Should Be Screened for HBV Infection=== | ||
The following groups should be tested for [[HBV infection]]:<ref name=USPTF-HepatitsB>U.S Preventive Services Task Force. Hepatitis B. (2016) https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=hepatitis+b Accessed on October 10th, 2016</ref> | The following groups should be tested for [[HBV infection]]:<ref name="USPTF-HepatitsB">U.S Preventive Services Task Force. Hepatitis B. (2016) https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=hepatitis+b Accessed on October 10th, 2016</ref> | ||
*Persons born in high or intermediate [[endemic]] areas | *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 | *United States–born people who were not [[vaccinated]] as infants and whose parents were born in regions with high [[HBV]] endemicity | ||
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*People with multiple sexual partners or history of sexually transmitted disease | *People with multiple sexual partners or history of sexually transmitted disease | ||
*Incarcerated people | *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 | *Persons who have ever used [[drug injection|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)'' | *Testing for [[HBsAg]] and anti-HBs should be performed, and [[seronegative]] persons should be vaccinated. ''(Grade I Recommendation)'' | ||
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===Recommendations for HCC Screening: AASLD Practice Guidelines === | ===Recommendations for HCC Screening: AASLD Practice Guidelines === | ||
The following groups should be screened with US examination every 6-12 months: ''(Grade II-2)''<ref name=Hepatology> 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</ref> | The following groups should be screened with US examination every 6-12 months: ''(Grade II-2)''<ref name="Hepatology">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</ref> | ||
* [[HBV]] carriers at high risk for [[HCC]] such as Asian men over 40 years and Asian women over 50 years of age | * [[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 [[cirrhosis]] | ||
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* Individuals of African descent over 20 years of age | * 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 | * 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) | 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 == | == References == | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Gastroenterology]] | |||
[[Category:FinalQCRequired]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Hepatology]] |
Latest revision as of 22:05, 29 July 2020
Hepatitis B |
Diagnosis |
Treatment |
Case Studies |
Hepatitis B screening On the Web |
American Roentgen Ray Society Images of Hepatitis B screening |
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 |
|
Asymptomatic/Nonpregnant adolescents and adults at high risk (HBV) |
|
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