Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Recomm Rep. 2023 Mar 10;72(1):1-25. doi: 10.15585/mmwr.rr7201a1.
Chronic hepatitis B virus (HBV) infection can lead to substantial morbidity and mortality. Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality. Effective vaccines to prevent hepatitis B are available. This report updates and expands CDC's previously published Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection (MMWR Recomm Rep 2008;57[No. RR-8]) regarding screening for HBV infection in the United States. New recommendations include hepatitis B screening using three laboratory tests at least once during a lifetime for adults aged ≥18 years. The report also expands risk-based testing recommendations to include the following populations, activities, exposures, or conditions associated with increased risk for HBV infection: persons incarcerated or formerly incarcerated in a jail, prison, or other detention setting; persons with a history of sexually transmitted infections or multiple sex partners; and persons with a history of hepatitis C virus infection. In addition, to provide increased access to testing, anyone who requests HBV testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks.
慢性乙型肝炎病毒 (HBV) 感染可导致严重的发病率和死亡率。尽管治疗不被认为是治愈性的，但抗病毒治疗、监测和肝癌监测可以降低发病率和死亡率。有效的乙型肝炎预防疫苗已经可用。本报告更新和扩展了疾病预防控制中心之前发布的《美国慢性乙型肝炎病毒感染者识别和公共卫生管理建议》（MMWR Recomm Rep 2008；57[No. RR-8]），涉及在美国进行乙型肝炎病毒感染筛查。新建议包括对 18 岁及以上成年人进行三次实验室检测，至少进行一次乙型肝炎筛查。该报告还扩大了基于风险的检测建议，包括以下与乙型肝炎病毒感染风险增加相关的人群、活动、暴露或情况：被监禁或以前被监禁在监狱、监狱或其他拘留场所的人；有性传播感染或多个性伴侣史的人；以及有丙型肝炎病毒感染史的人。此外，为了增加检测机会，任何要求进行乙型肝炎病毒检测的人都应该进行检测，无论是否披露风险，因为许多人可能不愿意披露污名化的风险。
