— Christine M. Kukka, Project Manager, HBV Advocate
Ten years after it recommended against screening the "general
population" for hepatitis B, an independent national task force that
creates prevention guidelines for primary care providers has finally
recognized that certain high risk groups in the U.S. should be screened
for hepatitis B.
Their recommendations, recently published in the Annals of Internal Medicine,
come after numerous studies faulted primary care providers for failing
to screen patients for hepatitis B and missing opportunities to treat
patients for liver disease and immunize family members against
hepatitis B virus (HBV) infections.
Other health care organizations, including the
U.S. Centers for Disease Control and Prevention (CDC), the Institute of
Medicine, and the American Association for the Study of Liver Disease,
have been recommending for years that primary care doctors screen
high-risk patients for hepatitis B, which has infected up to 2.2 million
Americans.
The U.S. Preventive Services Task Force (USPSTF)
recently issued clinical guidelines recommending that doctors screen
the following patients for hepatitis B:
- People from countries that have hepatitis B
rates exceeding 2% (which includes Asia, Africa, Central Europe and
parts of Central and South America).
- U.S.-born people whose parents immigrated from countries with high rates of HBV infection.
- HIV-positive people, injecting drug users, men who have sex with men, and
- Household contacts of people infected with HBV.
The task force's guidelines suggest that because
an effective vaccine to protect against the infection and effective
treatments for hepatitis B are now available, they decided to issue
these recommendations. However, both the vaccine and effective
treatments have been available for more than a decade.
"In the 2004 recommendation, the USPSTF focused
only on the general population," the authors wrote in the
recommendations. "In the current recommendation, the USPSTF focused on
high-risk populations as it considered new evidence on the benefits and
harms of antiviral treatment, the benefits of education or behavior
change counseling, and the association between improvements in
intermediate and clinical outcomes after antiviral treatment.” The task
force noted that it, "...found inadequate evidence that education or
behavior change counseling reduces disease transmission."
Source: www.uspreventiveservicestaskforce.org/uspstf/
uspshepb.htm
HBV Journal Review — June 1, 2014, Vol 11, no 6
Labels: Christine Kukka, USPSTF HBV Screening Recommendations
