CDC Expands Testing Recommendations for Chronic Hepatitis B

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Title: CDC Expands Testing Recommendations for Chronic Hepatitis B
URL: http://www.pslgroup.com/dg/22CDE6.htm
Doctor's Guide
September 19, 2008

ATLANTA -- September 19, 2008 -- The US Centers for Disease Control and Prevention (CDC) published new recommendations for healthcare providers that are designed to increase routine testing in the United States for chronic hepatitis B virus (HBV).

The recommendations are published in the CDC′s Morbidity and Mortality Weekly Report Recommendations & Reports.

The CDC recommends testing all individuals born in Asia and Africa as well as testing additional at-risk populations, including men who have sex with men (MSM) and injection-drug users (IDUs).

The guidelines also give health professionals guidance for effective management of chronically infected hepatitis B patients.

"Chronic hepatitis B affects the lives of more than 1 million Americans, many of whom do not even know they are infected. These new recommendations are critical to identifying people who are living with the disease without the benefits of medical attention," said John W. Ward, MD, CDC′s Division of Viral Hepatitis, Atlanta, Georgia.

"Testing is the first step to identify infected persons so that they can receive lifesaving care and treatment, which can break the cycle of transmission, slow disease progression, and prevent deaths from liver cancer."

The new testing recommendations build upon and reinforce past recommendations to test all pregnant women, infants born to infected mothers, household contacts, and sex partners of infected individuals, and people with HIV.

Along with continued testing of those groups, routine testing is now recommended for additional populations, including the following:

· Individuals born in Asia, Africa, and other geographic regions with >=2% prevalence of chronic HBV infections (previous CDC recommendations called for testing of people born in areas with >=8% prevalence). Expanded testing is essential since the rate of liver cancer deaths and chronic HBV in the United States remains high among foreign-born US populations from these areas.

· Routine testing is needed for MSM and IDUs since both have a higher prevalence of chronic HBV infection than the overall US population. Up to 3% of MSM and up to 6% of IDUs are estimated to be chronically infected with HBV, compared with three-tenths of 1% of the general population.

· Persons with abnormal liver function tests and persons who require immunosuppressive therapy.

The new CDC report also gives recommendations for referral of HBV-infected persons to specialists for ongoing monitoring and medical care. Such guidelines are needed now to assist providers, since most of the effective medications for chronic HBV treatment have become available only in the last 5 years.

In addition, the recommendations advise healthcare providers to provide culturally sensitive ongoing patient education, begin lifelong monitoring for progression of liver disease, and ensure protection of household members and other close contacts of infected persons.

SOURCE: Centers for Disease Control and Prevention

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