Adherence to chronic hepatitis B screening guidelines for persons from intermediate to high prevalence Countries

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• The Centers for Disease Control and Prevention (CDC) recommends screening for hepatitis B virus (HBV) infection in non-U.S. born individuals.
• Hepatitis B is a significant global health concern, particularly in regions with high endemicity.

Purpose of the Study:

• To assess adherence to CDC guidelines for HBV screening in non-U.S. born populations within primary care settings.
• To determine the prevalence of hepatitis B surface antigen (HBsAg) among screened individuals.

Main Methods:

• A retrospective cohort study utilizing electronic medical records from University of Washington primary care clinics.
• Identification of individuals from HBV-prevalent countries based on country of origin and language.
• Analysis of screening rates and HBsAg positivity in the general eligible population and women of reproductive age.

Main Results:

• Only 26.5% (617/2329) of eligible non-U.S. born individuals were screened for HBV.
• The prevalence of HBsAg among screened individuals was 5.7% (35/617).
• Among women of reproductive age (18-44 years), 26.3% (238/906) were screened, with a 2.9% (7/238) HBsAg positivity rate.

Conclusions:

• Current HBV screening practices for non-U.S. born persons in primary care are inadequate, leading to missed diagnoses.
• The high prevalence of HBsAg among those screened highlights the need for improved screening strategies.
• Urgent implementation and scaling up of HBV screening are necessary in primary care to address the burden of chronic hepatitis B infection.