Universal Adult Hepatitis B Screening and Vaccination as the Path to Elimination

So, Samuel; Terrault, Norah A.; Conners, Erin E.

doi:10.1001/jama.2023.2806

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…Each of these markers, respectively, would identify patients with active infection, immunity, and resolved infection that could be reactivated. People with negative results for all three tests are susceptible to HBV infection and should be vaccinated [ 15 ]. Awareness of whether the patient has resolved or depicts an active infection is crucial because many newer immunotherapies may potentially cause HBV reactivation [ 16 ].…”

Section: New Hbv Vaccines and Policiesmentioning

confidence: 99%

Prospects for Controlling Hepatitis B Globally

Soriano,

Moreno-Torres,

Treviño

et al. 2024

Pathogens

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Infection with the hepatitis B virus (HBV) is highly prevalent globally. Over 250 million people suffer from chronic hepatitis B, and more than 800,000 patients die each year due to hepatitis B complications, including liver cancer. Although protective HBV vaccines are recommended for all newborns, global coverage is suboptimal. In adults, sexual transmission is by far the most frequent route of contagion. The WHO estimates that 1.5 million new HBV infections occur annually. Oral nucleos(t)ide analogues entecavir and tenofovir are the most frequent antivirals prescribed as HBV therapy. Almost all patients adherent to the medication achieve undetectable plasma viremia beyond 6 months of monotherapy. However, less than 5% achieve anti-HBs seroconversion, and viral rebound occurs following drug discontinuation. Therefore, nucleos(t)ide analogues need to be lifelong. New long-acting formulations of tenofovir and entecavir are being developed that will maximize treatment benefit and overcome adherence barriers. Furthermore, new antiviral agents are in development, including entry inhibitors, capside assembly modulators, and RNA interference molecules. The use of combination therapy pursues a functional HBV cure, meaning it is negative for both circulating HBV-DNA and HBsAg. Even when this goal is achieved, the cccDNA reservoir within infected hepatocytes remains a signal of past infection, and HBV can reactivate under immune suppression. Therefore, new gene therapies, including gene editing, are eagerly being pursued to silence or definitively disrupt HBV genomes within infected hepatocytes and, in this way, ultimately cure hepatitis B. At this time, three actions can be taken to push HBV eradication globally: (1) expand universal newborn HBV vaccination; (2) perform once-in-life testing of all adults to identify susceptible HBV persons that could be vaccinated (or re-vaccinated) and unveil asymptomatic carriers that could benefit from treatment; and (3) provide earlier antiviral therapy to chronic HBV carriers, as being aviremic reduces the risk of both clinical progression and transmission.

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Section: New Hbv Vaccines and Policiesmentioning

confidence: 99%

Prospects for Controlling Hepatitis B Globally

Soriano,

Moreno-Torres,

Treviño

et al. 2024

Pathogens

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“…In 2020, the recommendation was expanded to recommend HCV testing for all adults. The Centers for Disease Control and Prevention’s recent recommendation for onetime universal HBV screening of all adults, coupled with the 2022 recommendation of the Advisory Committee on Immunization Practices for universal HBV vaccination of all adults, can lead to earlier diagnosis and entry into care for those who are chronically infected with HBV and timely vaccination of uninfected susceptible adults . Partnerships have been forged with the commercial sector to supplement information obtained from traditional surveillance systems to better understand trends in viral hepatitis diagnosis and treatment, and organized advocacy in support of viral hepatitis elimination has continued to gain ground since 2011.…”

mentioning

confidence: 99%

Overcome Health Inequities to Eliminate Viral Hepatitis

Valdiserri

Koh

Ward

2023

JAMA

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Parental Knowledge and Attitudes Towards Helicobacter Pylori Screening in Adolescents: A School-Based Questionnaire Study Among Guardians of Junior High School Students in Yokosuka City, Japan

Saito,

Uchiyama,

Matsuoka

et al. 2024

J Gastrointest Canc

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Purpose Helicobacter pylori (HP) infection, a risk factor for gastric cancer, is prevalent in Japan. Consequently, some municipalities across Japan are implementing HP screening and treatment programs for adolescents. However, little is known about parents’ attitudes and awareness regarding HP screening for their children. This study aimed to elucidate parental perspectives on HP screening for their children and identify the factors influencing these attitudes. Methods This study focused on the parents of first-year junior high school students in Yokosuka City, Kanagawa Prefecture, where an HP screening and treatment program had been implemented for adolescents. The survey questionnaire was distributed among parents in all 23 public junior high schools in Yokosuka City. Results Among the 618 respondents, 86.4% supported HP screening for their children. Regression analysis identified sufficient knowledge about HP (adjusted odds ratio (aOR) = 5.80; 95% confidence interval (CI), 2.10–16.03) and being in their 40s (aOR = 2.25; 95% CI, 1.35–3.77) as significant factors influencing supportive attitudes. For parents favoring the screening, common reasons included perceiving it as a promising opportunity (53.2%) and considering the test necessary (44.0%). In contrast, those who opposed screening frequently cited it as unnecessary (66.7%) or believed that their children did not have HP. Conclusions A significant proportion of parents in Yokosuka City, Japan, demonstrated a good understanding of HP and expressed a high level of interest in HP screening for their children. Further investigation of parents’ attitudes is essential for the effective implementation of adolescent HP screening programs.

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Universal Adult Hepatitis B Screening and Vaccination as the Path to Elimination

Abstract: This Viewpoint describes new recommendations from the CDC regarding universal screening of adults for hepatitis B virus infection.

Cited by 6 publications

References 9 publications

Prospects for Controlling Hepatitis B Globally

Prospects for Controlling Hepatitis B Globally

Overcome Health Inequities to Eliminate Viral Hepatitis

Parental Knowledge and Attitudes Towards Helicobacter Pylori Screening in Adolescents: A School-Based Questionnaire Study Among Guardians of Junior High School Students in Yokosuka City, Japan

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