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