Hepatitis B: the United States invites all adults to be tested at least once

Hepatitis B the United States invites all adults to be

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    Change of strategy against Hepatitis B in the United States: arguing that more than half of people affected by a chronic form do not know it, the Center for Disease Control and Prevention now recommends that all adults get screened at least once in their lifetime.

    More than half of people with chronic hepatitis B don’t know it. This is at least the finding of the American Center for Disease Control and Prevention (CDC), which is alarmed by the real spread of cases. Therefore, this Thursday, March 9, the CDC changed its tune and updated its guidelines for screening tests in the country: every adult should have a blood test, even if the risk of infection is not not considered increased. This is the first time the CDC has updated its guidance since 2008.

    Expand hepatitis B testing to curb the spread

    Hepatitis B is a vaccine-preventable virus that damages the liver and can cause both acute and chronic disease. The virus is spread through contact with infected blood or bodily fluids. Until now, HBV testing has therefore only been recommended for people at increased risk of infection, such as people who inject drugs, pregnant women and people living with HIV.

    But according to the CDC, current risk-based tests alone cannot identify most people living with chronic HBV infection. Indeed, the agency announces that in 2019, approximately 3,190 HBV infections were reported to the CDC, but after adjusting for under-reporting, that number jumped to 20,700!

    Early detection of cases could allow treatment to be initiated earlier, reducing the risk of liver damage, liver cancer and death. It could also prevent HBV from spreading to others.

    Who is affected by this change?

    The CDC thus passes 3 new groups in people at increased risk of HBV: people incarcerated, people who have had STIs or have several sexual partners and people with a history of infection with the hepatitis C virus.

    But starting now, everyone who requests an HBV test should receive it, the CDC said, “because many people may be reluctant to disclose that they are at risk for fear of stigma”. The CDC thus refers to infants born to HIV-positive women, people born outside the United States, or men in a homosexual relationship. Everyone can therefore be entitled to it, without justifying the reason for their concern.

    However, children aged 0 to 18 are not affected because the prevalence of infection is low and vaccination levels are high in this age group, which is no longer the case beyond: although the HBV vaccine is highly effective against the infection, approximately 70% of adults in the United States said they were unvaccinated in 2018.

    What screening is planned in France?

    In France, HBV screening is possible on simple medical prescription and is only compulsory in two situations:

    • Before a blood donation;
    • If you are pregnant.

    Hepatitis B (HBV) screening also targets people who are particularly at risk of being infected. But would undoubtedly benefit from an extension of this measure: chronic hepatitis B affects around 135,000 people in the adult population aged 18 to 75 and only 17.5% of these people are aware of their disease, according to Hepatitis Info Services.

    The topic is important: while most people are able to recover from HBV without treatment, about 1 in 20 people will develop chronic hepatitis, in which the virus stays in the liver and, over time, can cause liver damage. liver (cirrhosis of the liver), liver failure or even cancer.