Posted on 03/10/2023 1:48:44 PM PST by nickcarraway
New recommendations favor universal access to screening
A photo of a blue rubber gloved hand holding a test tube of blood labeled for testing for Hepatitis B All adults should be tested for a hepatitis B virus (HBV) infection at least once in their lifetime, and a wider range should get periodic retesting, according to new CDC recommendations.
The report recommended moving from a risk-based approach to a universal approach in order to increase awareness of infection and reduce chronic disease and premature death.
"Overall, risk-based testing has been insufficient to identify persons with HBV infection in the United States and has been a barrier to appropriately screening populations with a disproportionate prevalence of disease," Erin E. Conners, PhD, of the CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention, and colleagues wrote in Morbidity and Mortality Weekly Reportopens in a new tab or window.
Screening should be triple-panel, including HBV surface antigen (HBsAg), antibodies to them (anti-HBs), and total hepatitis B core antibody (anti-HBc), they wrote.
"A one-time HBV screening of adults would be complementary to the 2022 Advisory Committee on Immunization Practices (ACIP) recommendationopens in a new tab or window to vaccinate all adults aged 19-59 years for HBV infection because screening establishes any history of infection, and vaccination protects from future infection and need for additional testing," Conners and colleagues added.
Currently, there are an estimated 580,000 to 2.4 million people living with HBV infection in the U.S., according to the CDC report, and two-thirds of those might be unaware of their infection. An estimated 1.89 million people are chronically infected with HBV, which can lead to substantial morbidity and mortality. Of note, chronic HBV disproportionately affects people born abroad (about three-fourths of U.S. cases).
People chronically infected with HBV infection are at increased risk for liver cancer and cirrhosis and are 70-85% more likely to die prematurely than the general population.
"Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality," said Conners and colleagues.
Before 2008, screening recommendations were risk-based and included pregnant women, infants born to infected mothers or born with HIV, household contacts and partners of infected persons, and people exposed such as by needlestick injury or sexual assault. In a 2008 update,opens in a new tab or window screening recommendations were expanded to people born in places with high HBV prevalence, people who had behavioral exposures to HBV (men who have sex with men and injection drug users), those receiving cytotoxic or immunosuppressive therapy, and people with liver disease with an unknown etiology.
The current screening guidelines widened the recommendations further to recommend that "anyone who requests HBV testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks."
In addition, the CDC now recommends that testing in pregnancy occur in the first trimester of each pregnancy and "regardless of vaccination status or history of testing." If a pregnant person has been recently screened and has not been exposed to an HBV risk since screening, only HBsAg screening is recommended.
In parallel, the current report recommended continual periodic testing for those at higher risk, regardless of age, as long as the risk exposure is ongoing. It further expanded the definition of high-risk individuals to include people who are incarcerated or formerly incarcerated in a prison or other detention setting, people with a history of sexually transmitted infections or multiple sex partners, and those who have had hepatitis C.
The CDC noted that the rate of reported acute HBV infection in 2019 was 1.0 per 100,000 population in the U.S., whereas the rate has remained at 0.1 cases or below in those up to 19 years of age because of routine vaccination.
Adults have "suboptimal" vaccine uptake, Conners' group wrote, though a recommendation for HBV vaccination now appears in the 2023 adult immunization scheduleopens in a new tab or window.
Once an adult has had blood taken for HBV serologic testing, those who have not completed a vaccine series should be offered vaccination per ACIP recommendations at the same visit or at an associated provider visit, the report said. "Blood collection before vaccination is recommended because transient HBsAg positivity has been reported for up to 18 days after vaccination."
Ingrid Hein is a staff writer for MedPage Today covering infectious disease. She has been a medical reporter for more than a decade. Follow
No.
“Screen All Adults for Hepatitis B, CDC Says”
So like the big pharm executives were made billionaires by Joe Birdbrain ... I mean Biden so now the makers of the Hepatitis B tests will be made rich if this becomes a mandate.
“HBV disproportionately affects people born abroad (about three-fourths of U.S. cases).”
Close the borders.
Build the wall.
Remove the diseased to their shttholes of origin.
STOP forcing regulations onto the American people.
If a few years ago it was wrong to out people for being gay, but now it’s right for the government to screen everybody for Hepatitis B ... you might be a Democrat.
It had better not be mandatory!
Maybe its time we went back to "stigmatizing" bad behavior. There's a reason sodomy, recreational drug use and living in filth and squalor have been frowned upon throughout human history.
I got immunized from B before I went back to Vi39t Nam 20 years ago. I would not do it now because I do not trust needles or doctors any more. That shot is probably a good thing for people traveling to SEA who don’t stay in the tourist circuit. About 20% of Vietnamese are infected and liver cancer therefrom is a major health problem there. The problem stems from using chopsticks and dipping eating utensils for serving oneself from the common bowls of food in the middle of the spread.
DITTO ALL THAT!!!!!@!
The CDC cannot at all be trusted.
Thanks to the third worlders amonog us now.
My unit in RVN had to get a hepatitis shot, I do not recall the type of hepatitis it was for.
Rumor had it they used a SQUARE NEEDLE, cause it hurt like hell. I think it was called gamma globunim????
Widely hated.
(Another plot to get blood samples, and thus DNA, from every American)
My guess as well
They only proved that, repeatedly, with COVID-19(84).
Why do we need the CDC?
I don’t trust the CDC as far as I can throw my house.
“Hepatitis B is spread when blood, semen, or other body fluids from a person infected with the virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or during pregnancy or delivery.” - CDC
I think I’m safe.
And it’s a perfect description
Sadly
🛐🙏✝️
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