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16 June 2009, Vol 150, No. 12>
Summaries for Patients | 16 June 2009

Screening Pregnant Women for Hepatitis B Virus Infection: U.S. Preventive Services Task Force Recommendation FREE

[+] Article and Author Information

The summary below is from the full reports titled “Screening for Hepatitis B Virus Infection in Pregnancy: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement” and “Screening for Hepatitis B Virus Infection in Pregnant Women: Evidence for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement.” They are in the 16 June 2009 issue of Annals of Internal Medicine (volume 150, pages 869-873 and pages 874-876). The first report was written by the U.S. Preventive Services Task Force; the second report was written by K. Lin and J. Vickery.


Ann Intern Med. 2009;150(12):I-36. doi:10.7326/0003-4819-150-12-200906160-00003
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Who developed these guidelines?

The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that reviews published research and makes recommendations about preventive health care.

What is the problem and what is known about it so far?

Hepatitis B is a virus that spreads from person to person through contact with infected body fluids. For example, the virus can be spread by sexual intercourse or contaminated needles or from mother to baby at birth. Most people with hepatitis B recover within a few months, but some develop chronic inflammation (chronic hepatitis) or permanent scarring (cirrhosis) of the liver or liver cancer.

A 3-dose vaccine that contains small amounts of dead or altered virus can boost the body's normal defense (immune) system and help prevent hepatitis B and related complications. Patients should get the second and third doses 1 month and 6 months after the first dose. In the United States, it is recommended that all infants receive the first dose of hepatitis B vaccine before they leave the hospital after birth. However, further protection is needed for infants born to mothers with hepatitis B infection. These infants should receive hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth. Hepatitis B immune globulin is a substance that boosts the body's defense against infection with the virus.

Doctors can screen pregnant women for hepatitis B infection with a blood test to measure hepatitis B surface antigen. In 2004, the USPSTF recommended that all pregnant women get this test at their first prenatal visit. The Task Force wanted to review studies published since that time to update this recommendation.

How did the USPSTF develop these recommendations?

The authors reviewed published studies to identify the risks and benefits of screening pregnant women for hepatitis B infection. One benefit is that fewer babies develop hepatitis B infection.

What did the authors find?

The USPSTF found good evidence that screening pregnant women for hepatitis B infection decreases transmission of hepatitis B infection to infants of infected mothers. No published studies identified harms of screening. The USPSTF concluded that there is a high certainty that the benefits of screening pregnant women for hepatitis B infection outweigh any risks.

What does the USPSTF suggest that patients and doctors do?

All pregnant women should have a blood test for hepatitis B surface antigen at their first prenatal visit.

What are the cautions related to these recommendations?

These recommendations apply only to screening, which means testing women who have no signs of infection. The recommendations may change if new studies become available. However, the USPSTF has judged that it would take large, high-quality studies to overturn these recommendations.

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NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

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