What is viral hepatitis screening?
- Viral hepatitis is most commonly caused by the hepatitis A, B, and C viruses.
- Hepatitis B and C cause chronic liver injury, but hepatitis A does not.
- Screening tests are used to detect chronic hepatitis B and/or hepatitis C, but not hepatitis A.
- Hepatitis screening can also be performed to detect prior infection with hepatitis A, B, or C as well as response to previous vaccination against hepatitis B.
Screening can be done with simple and inexpensive blood tests.
Why should you get screened for chronic viral hepatitis?
- People with chronic hepatitis B and C often do not have symptoms until they have advanced liver disease -- cirrhosis and liver cancer.
- Early diagnosis enables people with chronic hepatitis B and C to be evaluated for the severity of their disease and for the need to receive antiviral treatment. Successful response to antiviral therapy can prevent progression of liver disease.
- Early diagnosis enables people with chronic hepatitis B and C to receive counseling on lifestyle changes such as decreasing alcohol consumption, which can reduce the risk of cirrhosis and liver cancer.
- Early diagnosis enables people with chronic hepatitis to receive vaccines that may prevent other infections that can in turn cause severe illness. (see Viral Hepatitis Prevention)
- Counseling of people with chronic hepatitis B and C can prevent further spread of infection. This is particularly the case with chronic hepatitis B. (see Viral Hepatitis Prevention)
Who should get screened for chronic hepatitis B infection?
- All pregnant women.
- All foreign born people (including immigrants and internationally adopted children) from geographic areas with chronic hepatitis B virus prevalence of 2% or greater, including Asia, the Pacific Islands, Africa, and Eastern Europe.
- All unvaccinated U.S. born people with at least one foreign-born parent from geographic areas with chronic hepatitis B virus prevalence of 2% or greater, including Asia, the Pacific Islands, Africa, and Eastern Europe.
- All chronic hemodialysis patients.
- HIV-positive people.
- People with unexplained abnormal liver enzyme levels.
- Children born to hepatitis B-infected mothers after completion of the vaccine series.
What tests should be used for hepatitis B screening?
Tests to be performed depend on the purpose of the screening.
- Hepatitis B surface antigen -- presence indicates active infection, further evaluation is indicated. (see Viral Hepatitis Treatment)
- Hepatitis B surface antibody -- presence indicates immunity, vaccination is not necessary.
- Hepatitis B core antibody (total) -- presence indicates prior or ongoing infection, further evaluation is necessary to differentiate whether infection is ongoing (hepatitis B surface antigen-positive) or resolved (hepatitis B surface antibody-positive).
Who should get screened for chronic hepatitis C infection?
- People who ever injected illegal drugs.
- People who received clotting factors made before 1987.
- People who received blood or organs before 1992.
- People who ever received long-term hemodialysis.
- People with unexplained abnormal liver enzyme levels.
- Healthcare, emergency medical, and public safety workers after needlestick or mucosal exposure to hepatitis C-positive blood.
- Children born to hepatitis C-positive mothers.
What tests should be used for hepatitis C screening?
- Hepatitis C antibody -- presence indicates prior or ongoing infection, and should be followed with a test for hepatitis C virus RNA. Presence of hepatitis C virus RNA indicates active infection and further evaluation is indicated. (see Viral Hepatitis Treatment)
Where can you be screened for hepatitis B and C?
- You can be tested in your doctor’s office or health clinic.
- You can purchase a home test kit for hepatitis C at your pharmacy or on the internet.
References
1. American Liver Foundation website at www.liverfoundation.org or call 1-800-GOLIVER (1-800-465-4837)
2. Vterans Affairs hepatitis C website at http://www.va.gov/hepatitisC
3. NIH Consensus Statement at http://consensus.nih.gov
4. Centers for Disease Control and Prevention at www.cdc.gov/hepatitis