Recommendations for identification and public health management of persons with chronic hepatitis B virus infection #

Weinbaum, Cindy M.; Mast, Eric E.; Ward, John W.

doi:10.1002/hep.22882

Cited by 526 publications

(728 citation statements)

References 65 publications

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“…Whether patients can afford care often influenced the types of serologic tests that physicians ordered, despite guidelines which recommend that all persons born in regions with high or intermediate endemicity be screened for HBV. [30][31][32][33][34][35] Furthermore, providers felt conflicted about diagnosing patients who could not afford follow-up treatment. Other studies have found variance in how practitioners handle HBV prevention and treatment.…”

Section: Resultsmentioning

confidence: 99%

Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups

Hwang

Roundtree

Engebretson³

et al. 2010

J GEN INTERN MED

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BACKGROUND: Physicians can play a significant role in helping to decrease the hepatitis B virus (HBV) burden among Asian Americans. Few studies have described knowledge and practice patterns in the medical community among different provider types regarding HBV and liver cancer.OBJECTIVE: Our study explores the HBV beliefs, attitudes and practice patterns of medical providers serving Asian American communities. DESIGN:We conducted three focus groups with primary care providers, liver specialists, and other providers predominantly serving Asian American community. We asked about practices and barriers to appropriate medical care and outreach. PARTICIPANTS:We moderated three focus groups with 23 participants, 18 of whom completed and returned demographic surveys. Twelve were of Asian ethnicity and 13 spoke English as a second language. Only eight screened at least half of their patients, most (72%) using the hepatitis B surface antigen test. APPROACH: We used grounded theory methods to analyze focus group transcripts.RESULTS: Participants frequently discussed cultural and financial barriers to hepatitis care. They admitted reluctance to screen for HBV because patients might be unwilling or unable to afford treatment. Cultural differences were discussed most by primary care providers; best methods of outreach were discussed most by liver specialists; and alternative medicine was discussed most by acupuncturists and other providers.CONCLUSIONS: More resources are needed to lower financial barriers complicating HBV care and encourage providing guideline-recommended screenings. Other providers can help promote HBV screening and increase community and cultural awareness.

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Section: Resultsmentioning

confidence: 99%

Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups

Hwang

Roundtree

Engebretson³

et al. 2010

J GEN INTERN MED

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“…This has the potential to increase the incidence of acute hepatitis B [51,52]. Recently, the Centers for Disease Control and Prevention (CDC) published updated and expanded guidelines for HBsAg testing and new recommendations for public health evaluation and management for persons with chronic infection and their contacts [53]. Routine testing for HBsAg now is recommended for additional populations with an HBsAg prevalence of 2% or more: persons born in geographic regions with an HBsAg prevalence of 2% or more, men who have sex with men, and injection drug users [53].…”

Section: Prevention Of Mother-to-child Transmissionmentioning

confidence: 99%

“…Recently, the Centers for Disease Control and Prevention (CDC) published updated and expanded guidelines for HBsAg testing and new recommendations for public health evaluation and management for persons with chronic infection and their contacts [53]. Routine testing for HBsAg now is recommended for additional populations with an HBsAg prevalence of 2% or more: persons born in geographic regions with an HBsAg prevalence of 2% or more, men who have sex with men, and injection drug users [53]. The CDC guidelines serve as a resource on the management of HBV infection for public health officials, organizations, and healthcare professionals involved in the development, delivery, and evaluation of the prevention of HBV.…”

Section: Prevention Of Mother-to-child Transmissionmentioning

confidence: 99%

Chronic hepatitis B in Asian women of childbearing age

Leung

2009

Hepatol Int

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Hepatitis B virus (HBV) infection is a serious clinical problem affecting approximately 2 billion people worldwide. An estimated 350 million live with chronic hepatitis B (CHB) infection and are at an increased risk for serious liver sequelae and death from acute or chronic consequences of CHB infection. Individuals with CHB have a 20-30% risk of early death from complications, including liver cirrhosis and hepatocellular carcinoma. In the Asia-Pacific region, half of the CHB burden results from vertical or mother-to-child transmission, with early childhood horizontal transmission accounting for the remaining half. Screening and vaccination are key factors in the successful prevention and control of HBV infection. Over the last 20 years, the implementation of screening programs and universal HBV vaccination for all individuals born in endemic areas have reduced the prevalence of HBV infection and HBV-related liver diseases among individuals younger than 30 years. Women of childbearing age are key stakeholders in preventing HBV infection and, as such, play a critical role in reducing the vertical and horizontal transmission of HBV. Further efforts are needed to implement screening and educational programs for women of childbearing age, particularly those with CHB, to prevent the transmission of HBV to newborns, spouses, other household members, and sexual partners. In addition, healthcare workers need to learn how to avoid iatrogenic transmission in the healthcare setting. This article reviews these issues and highlights areas in which their engagement with public health efforts serves to improve quality of life and society as a whole.

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“…16 The US Centers for Disease Control and Prevention has recommended that all patients be screened for HBV infection before administration of any immunosuppression. 17 Despite differences regarding which patients should be screened, all guidelines indicate that some form of systemic screening is needed to identify patients at risk for reactivation. However, HBV infection testing rates before chemotherapy are extremely low in non-HBV endemic countries.…”

mentioning

confidence: 99%

Prevention of acute exacerbation of chronic hepatitis B infection in cancer patients receiving chemotherapy in a hepatitis B virus endemic area

et al. 2015

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Reactivation of hepatitis B viral (HBV) infection in cancer patients undergoing chemotherapy may cause interruption of chemotherapy and lead to liver failure and death. In our institute, a computerized order entry-based alert system was introduced in September 2011 to remind healthcare providers of HBV testing when prescribing chemotherapy. Since August 2012, an order entry-based therapeutic control system has been applied to ensure HBV prophylaxis during chemotherapy. This retrospective cohort study included cancer patients receiving chemotherapy in the Kaohsiung Veterans General Hospital from November 2009 to June 2013. The prechemotherapy HBV screening rate, HBV prophylactic rate, and severe HBV acute exacerbation rate were compared between stages with different order systems. Newly diagnosed cancer patients (n 5 2512) were included. The HBV testing rate in the screening reminder stage was higher than that in the educational stage (93.5% versus 40.2%, P < 0.001), whereas the adequate HBV prophylactic rates in the two order entry-based stages were comparable (41.1% versus 39.2%). Patients in the order entry-based therapeutic control stage had a higher HBV screening rate (99.3% versus 40.2%, P < 0.001) and a higher HBV prophylactic rate (95.8% versus 39.2%, P < 0.001) than those in the educational stage. Additionally, the severe HBV acute exacerbation rate in the therapeutic control stage was lower than those in the educational and screening reminder stages (0% versus 1.2% and 1.2%, respectively; both P < 0.01). Conclusion: A computerized order entry-based therapeutic control system can provide excellent prechemotherapy HBV screening for cancer patients undergoing chemotherapy and can effectively prevent severe acute exacerbation of HBV infection in hospitals among HBV endemic areas. (HEPATOLOGY 2015;62:387-396) 4 The incidence of HBV reactivation in patients with lymphoma and resolved hepatitis B after rituximab-based therapy ranges from 1.5% to 23.8%. [5][6][7][8] Reactivation of HBV infection in cancer patients receiving chemotherapy may cause interruption of chemotherapy and, in severe cases, lead to liver failure and death. 9-11 Additionally, the prognosis of cancer may be compromised by disruption in anticancer treatment Abbreviations: ALT, alanine aminotransferase; anti-HBc, antibody to hepatitis B core antigen; CI, confidence interval; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma.From the

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Recommendations for identification and public health management of persons with chronic hepatitis B virus infection #

Cited by 526 publications

References 65 publications

Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups

Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups

Chronic hepatitis B in Asian women of childbearing age

Prevention of acute exacerbation of chronic hepatitis B infection in cancer patients receiving chemotherapy in a hepatitis B virus endemic area

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