New guidance released today by the U.S. Centers for Disease Control and Prevention (CDC) that recommend testing of all adults ages 18 and older will save lives, ultimately, said Chari A. Cohen, president of the Doylestown-based Hepatitis B Foundation.
The CDC will publish its Universal Adult Hepatitis B Screening Recommendations in the March 10 edition of its influential “Morbidity and Mortality Weekly Report” (MMWR). A preview was posted today (March 9) on the CDC website.
“The Hepatitis B Foundation is grateful for the advocacy work on this issue by our Hep B United Coalition partners, the many individual advocates nationwide who have been engaged on this issue and the Congressional Hepatitis Caucus, which has been very supportive over the years of hepatitis B initiatives and decreasing HBV-related disparities,” Dr. Cohen said.
For years, the Hepatitis B Foundation has advocated that universal screening is essential to successfully addressing hepatitis B in the U.S. Its team will continue advocacy efforts to encourage the U.S. Preventive Services Task Force to align with CDC’s final recommendation, the Foundation said.
The Hepatitis B Foundation is developing a comprehensive communications program, including a detailed white paper and a social media tool kit, to help ensure that physicians, other health care providers and public health professionals nationwide learn about the new recommendations.
A webinar for providers, through the Hep B United coalition, has been scheduled for 4 p.m. March 27. The webinar will address what the recommendations will mean for providers and how implementation of universal screening and vaccination will look. The speakers will include CDC representatives and Dr. Robert Gish, medical director of the Hepatitis B Foundation. Register for the webinar online here.
Previous guidelines in the U.S. were based on a person’s risk factors, which was stigmatizing, inefficient and burdensome to providers and patients. It’s important to note that about two-thirds of Americans with hepatitis B have no identified risk factors for the disease, so previous recommendations were missing a large portion of those infected.
The new recommendation calls for all adults to be screening using the hepatitis B triple panel (hepatitis B surface antigen, hep B surface antibody and hep B core antibody). The triple panel is preferred because it provides a comprehensive view of a person’s hepatitis B status and alerts the provider as to the necessary next steps, including vaccination for susceptible individuals or linkage to care for those infected.
In the U.S., up to 2.4 million people are chronically infected, yet only 25% of those individuals know they are infected. Without diagnosis and appropriate care and treatment, people with chronic hepatitis B are at significantly increased risk of cirrhosis and liver cancer.
Hepatitis B cases in the U.S. have been rising in recent years – up 11% between 2014 and 2018 – largely due to the opioid epidemic. The disease is one of the primary causes of liver cancer, the fastest-growing cancer in the U.S., and a leading cause of cirrhosis. Asian Americans, Pacific Islanders, and African Immigrants continue to be disproportionately impacted by hepatitis B and liver cancer. From 2003-2017, it was the second most common cause of cancer deaths in Asian American and Pacific Islander males. Asians and Black Americans living with HBV have an 11-fold risk of developing primary liver cancer in comparison to white Americans.
The U.S. is on the path to eliminating viral hepatitis by 2030. Combined with universal vaccination for all adults 19-59, the new screening guidelines are a significant step toward reducing health disparities, reducing new hepatitis B infections, and working toward elimination.