Hepatitis B Screening: Who Is Tested, What the Blood Tests Show and What Comes Next

What it involves

MedlinePlus explains that hepatitis B is a type of viral hepatitis, an infection of the liver caused by the hepatitis B virus. It can cause an acute, short-term infection or a chronic, long-term one, and it spreads through contact with blood, semen or other body fluids from a person who has the virus.

Who this is for

• Adults who have never been screened for hepatitis B
• People who were born in, or often travel to, parts of the world where hepatitis B is common
• Adults with diabetes, hepatitis C or HIV, a partner or household member with hepatitis B, or work that exposes them to blood
• Anyone with yellow skin or eyes, dark urine, or unexplained tiredness and nausea

What to expect

• Questions about your history, where you were born or have lived, and any past exposure
• A blood test, often a set called a hepatitis viral panel, that shows a new infection, an older active one or one that is no longer active
• A plan for repeat testing and liver checks, or a referral to a liver specialist, if a result is positive
• A conversation about prevention, including where to get the hepatitis B vaccine

Why screening matters when you feel fine

MedlinePlus says people with hepatitis B often have no symptoms, and that chronic infection may not cause any until complications develop, perhaps decades after the infection. For that reason it calls screening, which means testing without symptoms, important. You can also spread the virus to other people even when you feel well. The encyclopedia states that the CDC recommends all adults over age 18 be screened for hepatitis B, even when they have no symptoms. Hepatitis A is a different virus that spreads through contaminated food and water and usually clears on its own, as the hepatitis A guide explains, so a negative hepatitis B result says nothing about it, and the annual physical page for Wellington patients describes the checkup where screening can be discussed.

Who is at higher risk

Anyone can get hepatitis B, but MedlinePlus lists a higher risk for infants born to mothers who have it, people who share needles or drug equipment, sex partners of people with hepatitis B, men who have sex with men, people who live with someone who has it and share a razor, toothbrush or nail clippers, health care and public-safety workers exposed to blood, dialysis patients, people who have lived in or often traveled to parts of the world where it is common, and people with diabetes, hepatitis C or HIV. The encyclopedia names Japan, parts of Asia and the Middle East, West Africa and South Sudan among those areas. Hepatitis B can also spread through sexual contact, and the STI testing guide explains how testing for those infections is approached at a visit.

Symptoms when they do appear

Some people with acute hepatitis B have symptoms two to five months after infection, which MedlinePlus lists as dark yellow urine, diarrhea, fatigue, fever, gray or clay-colored stools, joint pain, loss of appetite, nausea or vomiting, abdominal pain, and yellowing of the eyes and skin, called jaundice. The jaundice guide explains the yellow color change, and the fatigue guide covers tiredness with other causes.

What the blood tests show

The hepatitis viral panel is a series of blood tests that can detect a new infection, an older infection that is still active and an older infection that is no longer active. For chronic infection, further tests look for liver damage, including albumin, liver function tests and prothrombin time, and a viral load test measures the amount of virus in the blood. Ultrasound or MRI of the liver is often recommended. The liver function tests guide explains the common liver numbers, and the hepatitis C screening guide covers a different virus that is also screened for in adults.

If the result is positive

MedlinePlus says acute hepatitis B usually needs no treatment, with rest, fluids and healthy food, and monitoring through blood tests, and that the illness most often goes away after two to three weeks. Some people with chronic hepatitis B take antiviral medicines, which can lower the virus in the blood and reduce the risk of cirrhosis and liver cancer, and people with it are screened for liver cancer. It also advises avoiding alcohol and checking with your provider before taking over-the-counter medicines or herbal supplements. That specialist care is arranged by referral.

Prevention and the vaccine

The best way to prevent hepatitis B is the vaccine. MedlinePlus says babies should get a first dose at birth, that children and people at high risk should be vaccinated, that the CDC recommends the vaccine for adults under 50, and that a vaccine or hepatitis B immune globulin given within 24 hours of contact with the virus may help prevent infection. Not sharing needles, razors, toothbrushes or nail clippers, and making sure tattoo and piercing tools are sterile, also lowers the risk. Serenity By A Dr. Sareen does not list vaccines among its services, so ask when you call where to get one.

Sources

• MedlinePlus: Hepatitis B (health topic)
• MedlinePlus: Hepatitis B (medical encyclopedia)