Protocol for hepatitis screening and follow-up of Southeast Asian refugees

Hepatitis B virus (HBV) infection is prevalent among Southeast Asian refugees. HBV infection causes acute and chronic hepatitis and cirrhosis, and is associated with primary hepatocellular carcinoma. Health care providers must be able to make an accurate diagnosis of acute or chronic HBV infection when performing medical evaluations of Southeast Asian refugees. It is essential that appropriate follow-up care and teaching regarding infection control be provided. In this article, a protocol is presented that aids interpretation of hepatitis B screening tests. The protocol uses testing for the immunoglobulin M antibody against hepatitis B core antigen (anti-HBc/IgM) to aid differentiation between acute and chronic HBV infection. If testing is interpreted to show the presence of the hepatitis B chronic carrier state, a second protocol is used to guide follow-up testing, treatment and referral of patients.