All adults living in the United States should be tested for hepatitis B virus (HBV) at least once in their lifetime due to the risk for substantial morbidity and mortality from infection, according to a new CDC report.
The report expanded previous guidelines for HBV screening and testing with several new recommendations, including universal screening of adults. The recommendations are based on comprehensive systematic literature reviews (MMWR Recomm Rep 2023;72[1]:1-25. doi: 10.15585/mmwr.rr7201a1).
New recommendations for HBV screening and testing include:
- All adults (>18 years) living in the United States should be tested at least once.
- Anyone who requests to be screened for HBV, despite risk, should be screened.
- People who are currently in or have been to jail, prison or any other detention facility should be screened.
- People who have or have had an HBV infection should be screened.
- People with any sexually transmitted infection, have had STIs and/or have multiple sex partners should be screened.
- During initial screening, healthcare providers should test for HBsAg, anti-HBs and total anti-HBc.
The CDC added that screening with three tests (triple panel) can identify active HBV patients that could be linked to care, patients with resolved infection but may be susceptible to reactivation, such as those who are immunosuppressed, and susceptible people who are in need of vaccination or have been vaccinated.
Investigators noted more than 10 mIU per mL of anti-HBs is a known to correlate with protection when testing follows a complete hepatitis B vaccine series.
The agency estimates there are 580,000 to 2.4 million cases of HBV infection in the United States, and more than half of the people infected are unaware of their infection. However, if left untreated, HBV infection can cause deadly health outcomes, including liver cirrhosis and hepatocellular carcinoma.
According to the CDC, people with HBV infection are 70% to 85% more likely to die prematurely.
Treatment for HBV infection is not usually indicated unless the case is severe. However, for those with chronic HBV infection, monitoring and counseling, including mental health support can be of benefit.
The agency will continue to review and revise these guidelines as new tests and treatments become available.
“Patients with acute infection should be counseled about their risk for developing chronic HBV infection, the risk for reactivation and the risk for transmission to others,” the investigators wrote. “Universal screening of adults for HBV infection is cost-effective compared with risk-based screening and averts liver disease and death. Although a curative treatment is not yet available, early diagnosis and treatment of chronic HBV infections reduces the risk for cirrhosis, liver cancer and death.”
—GEN Staff
From CDC materials
Originally published by our sister publication Infectious Disease Special Edition
