February 4, 2019, Comments of National Center for Health Research
Thank you for the opportunity to share our views regarding U.S. Preventive Services Task Force’s (USPSTF) draft recommendation for hepatitis B virus infection screening in pregnant women.
The National Center for Health Research is a nonprofit research center that analyzes and reviews research on a range of health issues, with particular focus on which treatment and prevention strategies are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work.
We agree with the “A” grade recommendation for hepatitis B virus infection screening in all pregnant women. As discussed in the recommendation and review, between 1998 and 2011, rates of maternal hepatitis B virus infection in the United States increased 80% from 58 to 105 cases per 100,000 deliveries.
Hepatitis B virus infection screening in pregnant women significantly reduces the transmission of the hepatitis B virus to their infants by identifying women in need of effective case management and interventions to prevent perinatal transmission. Screening tests can accurately identify patients with an infection and have a low false-positive rate. Treatments effectively prevent perinatal transmission.
As discussed in the review, evidence suggests that identifiable risk factors, including multiple sexual partners, injection drug use, exposure to human blood, and contact with an infected individual, were present in less than 65% of pregnant women who tested positive for hepatitis B virus infection. Therefore, since risk factors alone are not sufficient at detecting which women should be screened for the hepatitis B virus, a universal approach is appropriate. We agree that there is sufficient epidemiological evidence to support hepatitis B virus infection screening in all pregnant women. However, we also recognize that the number of pregnant women who have hepatitis B is small, so encourage USPSTF to consider methods to better identify high risk women as research becomes available.
In summary, we support USPSTF’s draft recommendation on hepatitis B virus infection screening in pregnant women.
Thank you for the opportunity to comment on this important issue.
The National Center for Health Research can be reached through Stephanie Fox-Rawlings, PhD at firstname.lastname@example.org.