hepatitis B

CDC/ACP Release HBV Vaccination, Screening Guidance

To improve hepatitis B (HBV) prevention and access to care, the American College of Physicians and Centers for Disease Control and Prevention have released new guidance on HBV screening, vaccination, and referring patients with HBV.

“This evidence-based synthesis of current clinical guidelines and research findings is intended to amplify existing guidelines and promote high-value clinical practice,” the authors wrote.
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Among the recommendations:

  • Adults at high risk for HBV due to sexual exposure, drug use, health care or public safety work, or travel to an HBV-endemic region should be vaccinated against HBV.
  • Vaccination against HBV is recommended for adults with chronic liver disease, end stage renal disease, including patients on dialysis, and persons with HIV, as well as adults who request vaccination.
  • HBV screening is recommended for individuals at high risk for HBV, which includes those born in countries with an HBV prevalence above 2%, men who have sex with men, persons who use drugs, household and sexual partners of persons with HBV, and incarnated persons.
  • Individuals receiving immunosuppressive therapy, persons with end-stage renal disease, including those on hemodialysis, blood and tissue donors, persons with HIV, persons with hepatitis C, persons with elevated alanine aminotransferase levels, infants born to mothers with HBV, and pregnant women should be screened for HBV.
  • Patients who are HBV positive should be referred for posttest counseling and should receive hepatitis B-directed care.

“Evidence-based strategies that effectively implement this advice are critical to accomplishing the goals of the national hepatitis B elimination plan,” the authors concluded.

—Melissa Weiss

Reference:

Abara WE, Qaseem A, Schillie S, McMahon BJ, Harris AM. Hepatitis B vaccination, screening, and linkage to care: best practice advice from the American College of Physicians and the Centers for Disease Control and Prevention [published online before print November 21, 2017]. Ann Intern Med. doi:10.7326/M17-1106.