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
I get quarterly blood work because of medications I take. Doc says my liver count is a little high but attributes to meds No need for any shots.
When I was 21, I was exposed to hepatitis B through none of the activities listed. I was working in a pathology lab that handled a lot of blood samples and got cut by a broken sample tube. Naturally that sample had a hepatitis warning label on it, so I had to get two gamma globulin shots a week apart. It must have worked, because I never came down with hep B. Even donated blood plenty of times over the years since then. No plans to get tested again.
So it’s not always sex and drugs that can give you hepatitis B.
“So it’s not always sex and drugs that can give you hepatitis B.”
No, and my wife was tested during her time as an RN (and got the shot as well IIRC). Not always sex or drugs.
But I’m not in health care, don’t handle blood, been married for 35+ years to one woman who doesn’t have it and don’t do drugs.
I like my odds.
Eff u CDC
Nope.
Ah
Same here, though I’ve only been married 22+ years so far.
Hepatitis B is pretty far down my list of concerns. I worry more about hepatitis A, since you can get that from contaminated food or water, but I don’t worry much about that either.
I want all homosexuals screened for hiv, std’s, aids, etc.
“No.”
________
You forgot, “Hell. No.”
That agency is probably a good one to put at the top of the defund list. (The CDC.)
When I worked in the relatively clean computer industry (way back in the early days) a co-worker got scratched by a hypodermic needle sticking out of a dumpster- that could happen to anyone, almost. He had to take those gamma global shots as well.
I think the country needs a non-corrupt CDC of some sort. The one we have is a corrupt menace to health.
The FDA I would strip of it’s police powers and privatize. We don’t have a Federal Toaster Administration, we do quite nicely depending on Underwriters Laboratories; and something similar would work to replace the FDA.
It’s too late. It’s already seeped into the population and there are now millions of infected chronic carriers.
It is generally asymptomatic so your liver may be quietly destroying itself. If you live or lived a licentious lifestyle you should get tested.
Gamma globulin is a treatment, not a caccine. Injections are usually given in an attempt to temporarily boost a patient’s immunity against disease. Injections are most commonly used on patients having been exposed to hepatitis A or measles
It’s never been conclusively proven COVID is from the CDC.
The CDC has no credibility.
IMO, it’s been proven to be useless. No, worse than that, it’s been harmful.
Sorry, may i have another, please.
That was probably the B variety. C is also pushed hard by the health authorities now but it is peripheral, gays and local hospitals in VN. Type A is more easily treated and is rare there as well as here.
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