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- Title
SCREENING AND DIAGNOSING HEPATITIS B VIRUS INFECTION: IMMIGRANT AND SPECIAL POPULATIONS.
- Authors
Hassanein, Tarek
- Abstract
Chronic infection with the hepatitis B virus (HBV) is considered to be prevalent in historically endemic areas (eg, Eastern Europe, Asia, Africa, the Middle East, and Pacific basin), where it is the leading cause of cirrhosis and hepatocellular carcinoma. In these areas, HBV is mostly transmitted perinatally or in early childhood (<5 years) and, therefore, follows a pattern that is somewhat distinct from adulthood-acquired infections, which are more commonly transmitted via sexual and injectiondrug use exposure and tend to occur more frequently in the United States and Western Europe. This article explores the different phases in the life cycle of HBV, as they relate to perinatal or childhood-acquired infection. A considerable portion of the discussion is centered on diagnostic and screening strategies, including the recently updated recommendations from Morbidity and Mortality Weekly Report that now call for screening of all persons born in geographic regions with hepatitis B surface antigen (HBsAg) prevalence of at least 2%, men who have sex with other men, past/current intravenous drug users, persons receiving cytotoxic or immunosuppressive therapy, and those with elevated alanine aminotransferase or aspartate aminotransferase levels of unknown etiology. Also discussed are public health implications of treating HBsAg (+) persons, particularly with respect to destigmatizing HBV as a disease that is solely transmitted via sexual contact and addressing common misconceptions held by at-risk immigrant groups.
- Subjects
MEDICAL screening; CIRRHOSIS of the liver; HEPATITIS viruses; LIVER cancer; INTRAVENOUS drug abusers; IMMIGRANTS; DISEASES
- Publication
Johns Hopkins Advanced Studies in Medicine, 2009, Vol 9, Issue 3, p82
- ISSN
1530-3004
- Publication type
Article