Screening for Hepatitis B: Key Information to Understand
In the fight against hepatitis B virus (HBV) infection, regular screening is a crucial weapon. This article provides a comprehensive guide on hepatitis B screening, focusing on adults, pregnant individuals, and infants.
Adults aged 18 years and older should be screened at least once in their lifetime for HBV infection, as recommended by the U.S. Preventive Services Task Force (USPSTF) and the Centers for Disease Control and Prevention (CDC) [1][5]. This screening is particularly important for those at increased risk, such as adults and adolescents. Medicare covers screening for high-risk non-pregnant adults [2].
For pregnant individuals, screening is recommended during each pregnancy, ideally in the first trimester, regardless of their vaccination status or previous testing results [1][2]. Early detection allows for timely prevention of mother-to-child transmission, a common route of chronic HBV infection globally [1][5].
Infants born to mothers who test positive for HBV or show other evidence of HBV infection must be tested for HBV. Follow-up testing for infants typically occurs from 2 to 6 months of age to ensure they are not infected perinatally [5].
The hepatitis B triple panel screening test is the primary tool for detecting acute or chronic HBV infection. This test includes HBsAg, HBsAb, and HBcAb [1]. A positive HBsAg test result suggests a person has a hepatitis B infection [1]. On the other hand, a positive HBsAb test indicates a person may be immune to HBV [1]. However, it's essential to note that doctors need to know the results of all three parts of the hepatitis B screening test to fully understand the HBcAb test results [1].
A positive HBcAb test suggests a current or past HBV infection [1]. In contrast, a negative HBsAb and HBcAb result may indicate a person has received the hepatitis B vaccine and is now protected [1].
Screening is necessary 1 or 2 months after receiving a hepatitis B vaccination [1]. Doctors may also recommend a screening test for those with symptoms of hepatitis B or atypical liver function test results [1].
It's important to note that the core antibody (HBcAb) does not provide protection or immunity to HBV [1]. If someone receives a positive hepatitis B result, they may begin treatment with antiviral medication and may need to make lifestyle changes such as quitting alcohol [1].
In summary, universal adult screening once in a lifetime, routine screening of all pregnant individuals at each pregnancy, and targeted testing of exposed infants are recommended to identify and manage HBV infections effectively and reduce transmission risks [1][2][5]. The CDC encourages every adult over 18 years old to have a hepatitis B screening test at least once [2]. For pregnant people, the CDC recommends attending a screening test for hepatitis B, preferably in their first trimester [1]. Infants born to mothers with HBV may need a screening test when they are 9-12 months of age [1].
Early identification of HBV infection helps prevent transmission to others and allows timely medical evaluation and treatment to reduce the risk of chronic liver disease, including cirrhosis and hepatocellular carcinoma (liver cancer) [1][3]. Screening during pregnancy is critical to prevent mother-to-child transmission, which is a common route of chronic HBV infection globally. Infants who test positive can receive appropriate prophylaxis and monitoring [1][5]. Chronic HBV carriers may remain asymptomatic but are at risk for severe liver complications; consistent testing and surveillance can prevent liver damage and improve health outcomes [1][3][4].
References:
[1] Hepatitis B: A Practical Guide for Clinicians. (2021). American Association for the Study of Liver Diseases. [2] Hepatitis B Virus Infection. (2021). U.S. Preventive Services Task Force. [3] Hepatitis B. (2021). Centers for Disease Control and Prevention. [4] Hepatocellular Carcinoma. (2021). American Cancer Society. [5] Hepatitis B. (2021). World Health Organization.
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