Hepatitis B screening: Difference between revisions
No edit summary |
No edit summary |
||
Line 5: | Line 5: | ||
==Overview== | ==Overview== | ||
High risk groups should be tested for [[HBV]] infection. These include immigrants/refugees from areas of intermediate or high [[endemic|endemicity]], persons with chronically elevated [[aminotransferases]], [[immunocompromised]] individuals, and persons with a history of injection drug use([[IDU]]). | High risk groups should be tested for [[HBV]] infection. These include immigrants/refugees from areas of intermediate or high [[endemic|endemicity]], persons with chronically elevated [[aminotransferases]], [[immunocompromised]] individuals, and persons with a history of injection drug use([[IDU]]). | ||
Additionally, screening for [[hepatocellular carcinoma]] should extend to any HBV carrier over 40 years with persistent or intermittent [[ALT]] elevation and/or high [[HBV]] [[DNA]] level >2,000 IU/mL. | |||
==Screening== | ==Screening== | ||
Line 20: | Line 19: | ||
*Persons who have ever used injecting drugs, [[dialysis]] patients, [[HIV]] or HCV infected individuals, pregnant women, and family members, household members, and sexual contacts of HBV infected persons. | *Persons who have ever used injecting drugs, [[dialysis]] patients, [[HIV]] or HCV infected individuals, pregnant women, and family members, household members, and sexual contacts of HBV infected persons. | ||
*Testing for [[HBsAg]] and anti-HBs should be performed, and [[seronegative]] persons should be vaccinated. ''(Grade I Recommendation)''}} | *Testing for [[HBsAg]] and anti-HBs should be performed, and [[seronegative]] persons should be vaccinated. ''(Grade I Recommendation)''}} | ||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | {| style="border: 0px; font-size: 90%; margin: 3px;" align=center | ||
|+ | |+ | ||
Line 56: | Line 44: | ||
**Testing for antibodies to HBsAg (anti-HBs) and hepatitis B core antigen (anti-HBc) (distinguish between infection and immunity) | **Testing for antibodies to HBsAg (anti-HBs) and hepatitis B core antigen (anti-HBc) (distinguish between infection and immunity) | ||
|} | |} | ||
===Recommendations for HCC Screening: AASLD Practice Guidelines 2009=== | |||
The following groups should be screened with US examination every 6-12 months: ''(Grade II-2)''<ref name="pmid15229781">{{cite journal |author=Lok AS, McMahon BJ |title=[AASLD Practice Guidelines. Chronic hepatitis B: update of therapeutic guidelines] |journal=[[Romanian Journal of Gastroenterology]] |volume=13 |issue=2 |pages=150–4 |year=2004 |month=June |pmid=15229781 |doi= |url=http://www.aasld.org/practiceguidelines/documents/bookmarked%20practice%20guidelines/chronic_hep_b_update_2009%208_24_2009.pdf |accessdate=2012-02-10}}</ref> | |||
* [[HBV]] carriers at high risk for [[HCC]] such as Asian men over 40 years and Asian women over 50 years of age | |||
* Persons with [[cirrhosis]] | |||
* Persons with a family history of [[HCC]] | |||
* Africans over 20 years of age | |||
* Any carrier over 40 years with persistent or intermittent [[ALT]] elevation and/or high [[HBV]] [[DNA]] level >2,000 IU/mL | |||
For [[HBV]] carriers at high risk for [[HCC]] who are living in areas where US is not readily available, periodic screening with [[AFP]] should be considered. (Grade II-2)}} | |||
Revision as of 21:09, 10 October 2016
Hepatitis B |
Diagnosis |
Treatment |
Case Studies |
Hepatitis B screening On the Web |
American Roentgen Ray Society Images of Hepatitis B screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
High risk groups should be tested for HBV infection. These include immigrants/refugees from areas of intermediate or high endemicity, persons with chronically elevated aminotransferases, immunocompromised individuals, and persons with a history of injection drug use(IDU). Additionally, screening for hepatocellular carcinoma should extend to any HBV carrier over 40 years with persistent or intermittent ALT elevation and/or high HBV DNA level >2,000 IU/mL.
Screening
Recommendations for Persons Who Should Be Tested for HBV Infection: AASLD Practice Guidelines 2009
The following groups should be tested for HBV infection:[1]
- Persons born in high or intermediate endemic areas
- United States– born persons not vaccinated as infants whose parents were born in regions with high HBV endemicity]
- Persons with chronically elevated aminotransferases
- Persons needing immunosuppressive therapy
- Men who have sex with men
- Persons with multiple sexual partners or history of sexually transmitted disease
- Inmates of correctional facilities
- Persons who have ever used injecting drugs, dialysis patients, HIV or HCV infected individuals, pregnant women, and family members, household members, and sexual contacts of HBV infected persons.
- Testing for HBsAg and anti-HBs should be performed, and seronegative persons should be vaccinated. (Grade I Recommendation)}}
Group | Screening Recommendations |
---|---|
Pregnant women |
|
Asymptomatic/Nonpregnant adolescents and adults at high risk (HBV) |
|
Recommendations for HCC Screening: AASLD Practice Guidelines 2009
The following groups should be screened with US examination every 6-12 months: (Grade II-2)[1]
- HBV carriers at high risk for HCC such as Asian men over 40 years and Asian women over 50 years of age
- Persons with cirrhosis
- Persons with a family history of HCC
- Africans over 20 years of age
- Any carrier over 40 years with persistent or intermittent ALT elevation and/or high HBV DNA level >2,000 IU/mL
For HBV carriers at high risk for HCC who are living in areas where US is not readily available, periodic screening with AFP should be considered. (Grade II-2)}}
References
- ↑ 1.0 1.1 Lok AS, McMahon BJ (2004). "[AASLD Practice Guidelines. Chronic hepatitis B: update of therapeutic guidelines]" (PDF). Romanian Journal of Gastroenterology. 13 (2): 150–4. PMID 15229781. Retrieved 2012-02-10. Unknown parameter
|month=
ignored (help)