ACP/CDC new
recommendations on hepatitis B screening and vaccination
The
American College of Physicians (ACP) and the Centers for Disease Control and
Prevention (CDC) have jointly issued new recommendations for care of patients with
hepatitis B including screening and vaccination with an aim to reduce chronic
hepatitis B infections by screening at-risk adults, increasing hepatitis B
vaccination rates, and linking infected persons to care.
Published
November 21, 2017 in the Annals of Internal Medicine, the best practice statements are as follows:
·
Hepatitis B vaccination is the most effective
measure to prevent Hepatitis B infection and its complications. All
unvaccinated adults, including pregnant women, at risk for infection due to
sexual, percutaneous, or mucosal exposure should be vaccinated against HBV.
Other high risk groups including health care and public safety workers at risk
for blood exposure; adults with chronic liver disease, end-stage renal disease
(including hemodialysis patients), or HIV infection; travelers to HBV-endemic
regions; and adults seeking protection from HBV infection should also be
advised vaccination.
·
Clinicians should screen (hepatitis B surface
antigen, antibody to hepatitis B core antigen, and antibody to hepatitis B
surface antigen) for HBV in high-risk persons, including persons born in
countries with 2% or higher HBV prevalence, men who have sex with men, persons
who inject drugs, HIV-positive persons, household and sexual contacts of
HBV-infected persons, persons requiring immunosuppressive therapy, persons with
end-stage renal disease (including hemodialysis patients), blood and tissue
donors, persons infected with hepatitis C virus, persons with elevated alanine
aminotransferase levels (≥19 IU/L for women and
≥30 IU/L for men), incarcerated persons, pregnant women, and infants born to HBV-infected mothers.
≥30 IU/L for men), incarcerated persons, pregnant women, and infants born to HBV-infected mothers.
·
All HBsAg-positive patients should be referred
for or provided posttest counseling and hepatitis B–directed care
(Source: Annals of
Internal Medicine, November 20, 2017)
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