MedPage Today (02.10.2014)
MedPage Today reported that the US Preventive Services Task Force drafted a recommendation that high-risk groups should undergo hepatitis B virus (HBV) screening. The draft recommendations identified the following high-risk populations: US residents born in countries where HBV prevalence was greater than 2 percent; US-born people who did not receive HBV vaccination as infants and whose parents came from regions with high HBV prevalence; HIV-positive people; injection drug users; men who have sex with men; and patients with weakened immune systems or those in treatment for kidney failure.
Although most US-born citizens had HBV vaccination at birth, between 700,000 and 1.4 million US residents had chronic HBV infections, according to the task force. Mark Ebell, MD, of the University of Georgia, noted that immigrants from high-prevalence countries and their doctors should consider the immigrants’ risk status and screen them for HBV if appropriate. Approximately 15–25 percent of people with chronic HBV died from liver cancer or cirrhosis.
US HBV immunization programs began in 1991. Since then, acute symptomatic HBV cases declined from 20,000 annual cases in the mid-1980s to only 2,890 cases in 2011, according to the task force. However, it was likely that HBV was underreported. The task force emphasized that HBV testing was more than 98 percent accurate for sensitivity and specificity and posed no health risk. “Convincing evidence” existed that HBV treatments improved intermediate outcomes, and “moderate evidence” existed for a reduced risk of liver cancer. The task force’s draft recommendations aligned with earlier recommendations from CDC and the American Association for the Study of Liver Diseases.
The draft recommendations would be available for comment until March 10 at http://www.uspreventiveservicestaskforce.org/.