Hepatitis B screening recommended for all adults

Federal authorities have recommended that all adults be tested for hepatitis B, a virus that can lead to liver damage and cancer.

The Centers for Disease Control and Prevention said Thursday that people 18 or older should get tested at least once for the virus, which is spread through contact with infected blood or body fluids. According to the CDC, approximately 580,000 to 2.4 million people live with chronic hepatitis B in the United States, and two-thirds may not be aware they are infected. Universal adult screening is inexpensive and could prevent liver disease and death, the agency said.

The CDC recommended in 2008 that only those considered to be at high risk be screened. The agency said Thursday that risk-based testing failed to identify most people living with chronic hepatitis B. CDC.

“Patients often worry about being discriminated against, stigmatized, so they don’t always tell their providers everything that would be relevant,” said Dr. Daniel Griffin, infectious disease physician and medical instructor clinic at Columbia University. “These recommendations remove that.”

Hepatitis B can be transmitted during pregnancy or childbirth, sexually, or by sharing infected needles or other drug injection equipment. Most adults who are infected clear the virus without any problems, but a small percentage develop a chronic infection that increases their risk of developing liver cancer, scarring and failure. People born outside the United States are more likely to have chronic hepatitis B, the CDC said, especially people born in areas where the hepatitis B vaccine is not widely available or required.

According to the CDC, people with chronic hepatitis B are 70-85% more likely to die prematurely than the general population. Wider screening would help catch chronic infections before they later lead to serious and possibly fatal liver problems, doctors said.
In an analysis of 770,000 cases of hepatocellular carcinoma worldwide, more than half of the cases were due to chronic HBV infection. Universal screening strategies will get more people on treatment and help prevent liver cancer, doctors said.

Write to Sarah Toy at sarah.toy@wsj.com

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