All adults should be screened for hepatitis B at least once, CDC says


A new recommendation from the US Centers for Disease Control and Prevention says all adults should be screened at least once in their lifetime for hepatitis B, a condition linked to liver disease and cancer.

The agency estimates that 580,000 to 2.4 million people are living with hepatitis B, known as HBV, and two-thirds may not be aware of their infection. Many people infected with hepatitis B clear the virus, but acute infection can lead to chronic hepatitis B, which is linked to an increased risk of liver cancer and cirrhosis. People with chronic hepatitis B are 70-85% more likely to die prematurely.

“Chronic HBV infection can cause significant morbidity and mortality, but is detectable before the development of severe liver disease using reliable, inexpensive screening tests,” the agency said in a report released Thursday.

Hepatitis B is spread through contact with infected blood or bodily fluids, which can happen during sex, injection drug use, pregnancy, or childbirth.

The previous CDC recommendation was made in 2008 and called for testing for those at high risk. Now the agency recommends screening for anyone 18 and older at least once. The agency continues to recommend that pregnant women be screened during every pregnancy, whether they have been vaccinated or tested in the past. People at high risk — including those who are incarcerated, have multiple sex partners, or have a history of hepatitis C infection — should be tested periodically.

Symptoms of acute hepatitis B infection may include fever, fatigue, abdominal pain, dark urine, and jaundice, among others; these signs may take months to appear and last for weeks or months, but most people clear the infection. People who develop chronic hepatitis B often feel fine and have no symptoms, sometimes for decades. But if symptoms do appear, they may resemble an acute infection and may be a sign of advanced liver disease.

Several drugs are available to treat people with chronic hepatitis B. There is also a very effective hepatitis B vaccine.

“Although a cure is not yet available, early diagnosis and treatment of chronic HBV infections reduces the risk of cirrhosis, liver cancer, and death,” the CDC said. “In addition to vaccination strategies, universal adult screening and appropriate screening of those at increased risk for HBV infection will improve health outcomes, reduce the prevalence of HBV infection in the United States, and make advancing viral hepatitis elimination goals.”

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