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Screening for Hepatitis B infection in adolescents and adults

This month's issue of the Annals of Internal Medicine reports on the U.S. Preventive Services Task Force recommendation statement on screening for Hepatitis B virus infection.

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In 2004, the U.S. Preventive Services Task Force (USPSTF) recommended against screening for hepatitis B virus (HBV) infection.

Dr Roger Chou and colleagues from Oregon, USA updated the 2004 USPSTF review on screening for HBV infection in adolescents and adults.

The team evaluated MEDLINE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and PsycINFO.

The research team identified randomized trials of screening and treatment and observational studies of screening or the association between intermediate and clinical outcomes after antiviral therapy.

There was 1 investigator that abstracted data, and a second investigator checked them.

Antiviral therapy was associated with a higher risk for withdrawal due to adverse events
Annals of Internal Medicine

The team reported that 2 investigators independently assessed study quality.

No study directly evaluated the effects of screening for HBV infection versus no screening on clinical outcomes.

The team observed that vaccination against HBV infection was associated with decreased risk in high-risk populations.

On the basis of 11 primarily fair-quality trials, the team found that antiviral therapy may be more effective than placebo for reducing the risk for clinical outcomes associated with HBV infection.

However, differences were not statistically significant.

On the basis of 22 primarily fair-quality trials, the research team noted that antiviral therapy was more effective than placebo for various intermediate outcomes, with limited evidence that first-line antiviral agents are superior to lamivudine.

Antiviral therapy was associated with a higher risk for withdrawal due to adverse events than placebo, but risk for serious adverse events did not differ.

Dr Chou and team comment, "Antiviral treatment for chronic HBV infection is associated with improved intermediate outcomes, but more research is needed to understand the effects of screening and subsequent interventions on clinical outcomes, and to identify optimal screening strategies."

Ann Intern Med 2014;161(1):31-45
08 July 2014

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