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USPSTF: Screen pregnant women for hepatitis B
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The U.S. Preventive Services Task Force recently gave an ‘A’ level recommendation to screening women for hepatitis B during their first prenatal visit, according to a report recently published in JAMA.
“Although there are guidelines for universal infant HBV vaccination, rates of maternal HBV infection have increased annually by 5.5% since 1998. Children infected with HBV during infancy or childhood are more likely to develop chronic infection. Chronic HBV infection increases long-term morbidity and mortality by predisposing infected persons to cirrhosis of the liver and liver cancer,” the task force wrote.
The USPSTF also found that other “effective” interventions to preventing perinatal transmission of HBV included vaccinating infants born to HBV-negative mothers within 24 hours of their birth and completing the HBV vaccination series by the time an infant is 18 months old. In addition, the task force noted that enrolling these mothers and their children in case management “provided an overall substantial health benefit.”
The recommendations are based on 499 studies and 5,688 titles and abstracts, according to Jillian T. Henderson, PhD, MPH, Center for Health Research, Kaiser Permanente, Portland, Oregon and colleagues.
The USPSTF ‘A’ level recommendation to screen pregnant women for HBV mirrors the task force’s previous recommendations a decade ago, the task force wrote. The USPSTF also noted that the CDC Advisory Committee on Immunization Practices, American College of Obstetricians and Gynecologists and American Academy of Family Physicians all have recommendations similar to the task force in this area.
Data show there were 85.8 cases of maternal HBV infection for each 100,000 deliveries from 1998 to 2011, according to the task force.
Neil S. Silverman, MD , of the department of obstetrics and gynecology, David Geffen School of Medicine at University of California, Los Angeles, offered additional benefits following the USPSTF recommendations could have besides lowering that rate, in a related editorial.
“Adherence to these recommendations also allows for discussions and implementation of treatment modalities ... including maternal HBV-targeted antiviral therapy during pregnancy as an adjunct to neonatal immunoprophylaxis to address the risk of fetal infection in the face of high levels of maternal viremia, as well as the ability to refer women for chronic treatment of their HBV disease to forestall or prevent long-term complications of infection,” he wrote. – by Janel Miller
References:
Henderson JT, et al. JAMA. 2019;doi: 10.1001/jama.2019.1655.
Silverman, NS. JAMA. 2019;doi:10.1001/jama.2019.8252.
USPSTF. JAMA. 2019;doi:10.1001/jama.2019.9365.
Disclosures: Neither Henderson nor Silverman report any relevant financial disclosures. Please see the reports and the USPSTF website for all other relevant financial disclosures.