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

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The full report is titled “Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 1 July 2014 issue of Annals of Internal Medicine (volume 161, pages 58-66). The author is M.L. LeFevre, on behalf of the U.S. Preventive Services Task Force.

This article was published online first at www.annals.org on 27 May 2014.

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Ann Intern Med. 2014;161(1):I-28. doi:10.7326/P14-9020
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Who developed these recommendations?

The U.S. Preventive Services Task Force (USPSTF) developed these recommendations. The USPSTF is a group of health experts that reviews published research and makes recommendations about preventive health care. The USPSTF and its review of the published research are supported by the Agency for Healthcare Research and Quality.

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

Hepatitis B virus (HBV) infection 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 HBV infection recover in a few months, but some develop chronic inflammation (chronic HBV infection), permanent scarring (cirrhosis) of the liver, or liver cancer.

An estimated 700,000 to 2.2 million people in the United States have chronic HBV infection. People at high risk for HBV infection include those from regions in which 2 or more of every 100 people have HBV infection. Currently, such regions include China, sub-Saharan Africa, and Southeast Asia. People with HIV infection, injection drug users, household contacts of people with HBV infection, and men who have sex with men are also at high risk for HBV infection. Vaccination can prevent HBV infection, and an increasing proportion of the U.S. population is vaccinated, including routine vaccination of infants.

Screening for HBV infection with a blood test could identify people with chronic infection who may benefit from earlier evaluation and management of the disease. In 2004, the USPSTF recommended against screening the general population for HBV infection because there was little evidence that screening improved patient outcomes, infection rates were fairly low, and most people with infection do not develop chronic infection. They also found limited evidence that treatment improved patient outcomes. The USPSTF wanted to review studies published since that time to update this recommendation.

How did the USPSTF develop these recommendations?

The USPSTF reviewed published studies to identify the risks and benefits of screening for HBV infection.

What did the authors find?

The USPSTF found that the screening test is accurate and current treatments improve health outcomes. They judged that screening is of moderate net benefit in people at high risk for infection.

What does the USPSTF recommend that patients and doctors do?

Patients at high risk should be screened for HBV infection. High-risk persons include those from regions with high rates of HBV infection, those who have HIV infection, injection drug users, household contacts of people with HBV infection, and men who have sex with men. Another important risk factor is lack of vaccination during infancy of persons born in the United States to parents from a high-risk region.

What are the cautions related to these recommendations?

These recommendations apply only to screening nonpregnant adults who have no signs of infection or liver disease.





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