The rules about whom to screen and vaccinate for hepatitis B are now more clinician-friendly.
Clinical Assistant Professor, Department of Medicine, Perelman School of Medicine at University of Pennsylvania ; Internist, Department of Medicine, Hospital Medicine Section, Pennsylvania Hospital, Philadelphia, Pennsylvania Associate Professor of Clinical Medicine, Department of General Internal Medicine, Lewis Katz School of Medicine; Staff Physician, Department of General Internal Medicine, Temple Internal Medicine Associates, Philadelphia, Pennsylvania The Curbsiders.
But with that comes the question of, how do I know if someone has been vaccinated or needs vaccination, or has an infection or not? So, we're also doing universal screening. Everyone should be screened for HBV at least one time, and then again if their risk factors change. It has been simplified in a lot of ways, although it does give us a chance to look at HBV serologies a lot more frequently, which can be confounding if you're not familiar with them.
Now, Paul, there is the counseling. I thought this was interesting to talk about because if someone has HBV, they should basically live alone and not interact with others, right? No sports, no sharing. If they go to Buca di Beppo, they should not be eating family style. Is all this true? Of course, none of that is accurate.
For patients with ongoing injection drug use, harm reduction is key. You obviously want to vaccinate them right away and make sure they have immunity because their risk is so high. That might be a time to use one of the fancier vaccines. It's also important to counsel that breastfeeding is also fine in the setting of chronic HBV infections. You also want to do some counseling about how to keep their liver from getting sicker because HBV can cause longstanding impact on the liver.
HBV - Hepatitis B Virus HBV Liver Preventive Screening Screening Fatty Liver Steatorrhoeic Hepatosis Steatosis Hepatis Liver Disease Hepatic Impairment Immunizations Vaccination Pennsylvania Vaccine Vaccines Biliary Disease Gallbladder Disease Nonalcoholic Fatty Liver Disease NAFLD Non-Alcoholic Fatty Liver Disease Non-Alcoholic Fatty Liver Disease (NAFLD) Fellowship
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