— Christine M. Kukka, Project Manager, HBV Advocate
Among 5.6 million U.S. veterans treated at Veterans Administration clinics during 2013, only 21.8% had been screened for hepatitis B during the prior 14 years, according to a report by VA researchers published in the December 2014 issue of the Annals of Internal Medicine.
National medical guidelines recommend HBV screening in anyone who has hepatitis C, HIV or a sexually-transmitted infection, signs of liver damage, is an injecting drug user, or is taking immune-suppressing medication that can weaken the immune system.
However, VA health providers screened only:
53.5% of injecting drug users
51.4% of veterans with sexually transmitted infections
70.7% of those with elevated alanine aminotransferase (ALT) levels, which indicate liver damage
83.5% of those with hepatitis C virus infection
And 89.7% of those with HIV infection.
People of Asian descent are also at high risk of hepatitis B, yet the VA screened only 26.6% of Asian-American patients for hepatitis B.
Researchers discovered that very few of the veterans were infected with HBV–0.84% overall tested positive for the hepatitis B surface antigen (HBsAg). However, that rate was three-times higher than what federal health officials predict to be the national average from its NHANES (National Health and Nutrition Examination Survey) data and the infection rate was twice what the U.S. Centers for Disease Control and Prevention predicts to be the national infection rate.
Among those screened by VA clinics, HBV infection was found in:
4.93% of Asian-American patients
1.53% of African-American patients
1.38% of injecting drug users
1.71% of patients with sexually transmitted infections
1.29% of patients with elevated ALT levels
And in 5.14% of HIV-infected veterans.
As expected, HBV infection was greatest in high-risk patients, underscoring the importance of screening veterans considered to be at risk of infection.
The VA's substandard screening rates, especially in veterans at high risk of infection, shows that teaching VA health officials about the importance of screening is needed.
"Complete screening in high-risk groups could identify substantial numbers of HBV-infected persons and patients eligible for vaccination who are at continued high risk of HBV infection," researchers wrote. "Such screening efforts are needed to accurately characterize and address the burden of HBV infection."
Labels: screening, VA
