PLoS ONE (Jan 2014)

Current state of and needs for hepatitis B screening: results of a large screening study in a low-prevalent, metropolitan region.

  • Julie Bottero,
  • Anders Boyd,
  • Maud Lemoine,
  • Fabrice Carrat,
  • Joel Gozlan,
  • Anne Collignon,
  • Nicolas Boo,
  • Philippe Dhotte,
  • Brigitte Varsat,
  • Gerard Muller,
  • Olivier Cha,
  • Nadia Valin,
  • Jean Nau,
  • Pauline Campa,
  • Benjamin Silbermann,
  • Marc Bary,
  • Pierre-Marie Girard,
  • Karine Lacombe

DOI
https://doi.org/10.1371/journal.pone.0092266
Journal volume & issue
Vol. 9, no. 3
p. e92266

Abstract

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BackgroundIn low hepatitis B virus (HBV)-prevalent countries, most HBV-infected persons are unaware of their status. We aimed to evaluate whether (i) previous HBV-testing, (ii) physicians decision to screen, and (iii) CDC's recommendations identified infected individuals and which risk-factor groups needing testing.MethodsDuring a mass, multi-center HBV-screening study from September 2010-August 2011, 3929 participants were screened for hepatitis B surface antigen (HBsAg), anti-HBs and anti-Hepatitis B core antibodies (anti-HBcAb). Questions on HBV risk-factors and testing practices were asked to participants, while participants' eligibility for HBV-testing was asked to study medical professionals.Results85 (2.2%) participants were HBsAg-positive, while 659 (16.8%) had either resolved HBV infection or isolated anti-HBcAb. When comparing practices, HBV-testing was more likely to occur in HBV-infected participants if Centers for Disease Control and Prevention (CDC) recommendations were used (Sensitivity = 100%, 95%CI: 95.8-100) than physicians' discretion (Sensitivity = 87.1%, 95%CI: 78.0-93.4) or previous HBV-test (Sensitivity = 36.5%, 95%CI: 26.3-47.6) (pConclusionsMissed opportunities of HBV-screening are largely due to underestimating country of origin as a risk-factor. Applying CDC-recommendations could improve HBV-screening, but with the disadvantage of many tests. Further development of HBV-testing strategies is necessary, especially before severe disease occurs.