ACP/CDC new recommendations on hepatitis B screening and vaccination

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.

·         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)

Study suggests possible airborne Hepatitis B virus transmission

Study suggests possible airborne Hepatitis B virus transmission A study from Korea has reported that the hepatitis B virus (HBV) can be detected in surgical smoke from laparoscopic surgeries on patients with hepatitis B. Eleven 11 patients who underwent laparoscopic or robotic abdominal surgeries between October 2014 and February 2015 at Korea University Anam Hospital were included in the study. A high efficiency collector was used to obtain surgical smoke in the form of hydrosol. The smoke was analyzed by using nested PCR. All 11 patients had positive hepatitis B surface antigen (HBsAg) prior to the surgery, while two had detectable HB surface antibody (HBsAb), two were positive for hepatitis B e antigen, and three were on anti-HBV medications. The hepatitis B virus was detected in surgical smoke in 10 of the 11 cases. Although preliminary, these findings highlight the need to recognize and understand the risk when treating patients with HBV and take steps to control surgical smoke during laparoscopic procedures to protect doctors and other healthcare workers from exposure to the virus. The study is reported online August 2, 2016 in the journal Occupational & Environmental Medicine.