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Task force seeks comments on draft of hepatitis B screening guidelines

Draft recommendations on hepatitis B screening from the U.S. Preventive Services Task Force are now available for public comment.

The recommendations urge screening for hepatitis B virus in people at high risk, including:

• People born in regions with a high prevalence of HBV infection (China, Vietnam, Laos, Cambodia, Myanmar, Afghanistan, Yemen, the Dominican Republic, Tonga, Micronesia, Ethiopia, Kenya, Somalia, Uganda, Eritrea, Zimbabwe, Cameroon, Sudan, Western Africa (including Nigeria, Ghana, Liberia, Sierra Leone, Senegal, and Guinea), Albania, and Moldova
• U.S.-born children of parents born in these regions
• HIV-positive individuals, men who have sex with men and users of injection drugs
• Patients undergoing hemodialysis or those with a weakened immune system

“Some persons with combinations of risk factors who do not fall into one of the above individual risk factor groups may also be at increased risk for HBV infection,” the draft recommendations say. “However, reliable information about combinations of risk factors is not available. Clinicians should exercise their judgment in deciding whether these individuals are at high enough risk to warrant screening.”

The report suggests screening is “probably appropriate” in settings that treat a large proportion of individuals at increased risk, such as sexually transmitted infection clinics, HIV testing and treatment centers, health care settings that provide services for injection drug users or men who have sex with men, and prisons.

The prevalence of HBV infection is low in the general U.S. population, and most infected individuals do not develop complications, the report concludes. Therefore, “screening is not recommended in the general population.”

The tentative recommendations are based on an accompanying Evidence Report. Both documents are available for comment until 5 p.m. EST, March 10.