Community-based hepatitis B screening programs in the United States in 2008

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Hepatitis B Virus (HBV) Research

Background:

• The Centers for Disease Control and Prevention (CDC) recommends hepatitis B surface antigen (HBsAg) testing for foreign-born individuals from high-prevalence areas (> or = 2%).
• Independent community organizations are primary providers of HBsAg screening in the United States.
• Understanding the scope and effectiveness of these community-based screening programs is crucial for public health strategies.

Purpose of the Study:

• To gather information on community-based HBsAg screening programs in the United States.
• To assess the reach, target populations, and effectiveness of these screening initiatives.
• To evaluate the contribution of community programs to meeting national HBV screening recommendations.

Main Methods:

• Identification of potential screening programs through known contacts, interviews, and internet searches.
• Data collection via email surveys and follow-up phone calls.
• Analysis of program location, number screened, services offered, target demographics, and HBsAg prevalence.

Main Results:

• 31 community HBsAg screening programs were contacted, screening an estimated 21,817 individuals in the past year.
• An average HBsAg prevalence of 8.1% was observed among those screened.
• Programs primarily targeted individuals from Asia, with limited screening of those from Africa, Eastern Europe, or US-born individuals at behavioral risk; geographic gaps in screening were noted.

Conclusions:

• Community HBsAg screening programs are effective in identifying individuals with HBV infection, as indicated by high prevalence rates.
• Current community-based efforts, while valuable, are likely insufficient to meet the CDC's recommended HBV screening needs.
• Targeted expansion and improved geographic distribution of screening programs are necessary to address the full scope of the HBV epidemic.