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©2006 Baishideng Publishing Group Co.
World J Gastroenterol. Sep 7, 2006; 12(33): 5272-5280
Published online Sep 7, 2006. doi: 10.3748/wjg.v12.i33.5272
Published online Sep 7, 2006. doi: 10.3748/wjg.v12.i33.5272
Table 1 Characteristics of the most common liver diseases and feasibility of screening
Hepatitis C | Hepatitis B | Fatty liver | Hemochromatosis | |
Disease common and causing morbidity/mortality | Yes | Yes | Common, but increased mortality only if advanced NASH | Common, but only 1% of screened population with complications[13] |
Target population identifiable | High risk groups | High risk groups | Obese, diabetics | Northern European ancestry |
Screening test | HCV Antibody test | HBsAg test | Ultrasound | Transferrin saturation or genetic testing (unsettled) |
Performance of test | Good | Good | Low PPV and NPV for fibrosis | Under investigation |
Effective therapy | 50% cure[14] | 4%-24% HBsAg loss, 70% no progression[15,16] | Only lifestyle modification | Yes, but may be unnecessary |
Table 2 Indications for screening with anti-HCV antibody
Risk factors for which testing is indicated by all the guidelines | Risk factors for which testing is indicated by some of the guidelines | Additional risk factors for which testing is not formally recommended |
Intravenous drug use (past and present) | Populations with high HCV prevalence[12,30] | Injections with reusable glass syringes[32] |
Blood transfusion or transplantation before 1992 (or by known HCV positive donor) | Incarceration[12,33] | Heavy marijuana use[34] |
Administration of clotting factors before 1997 | Hepatitis B virus infection[12,33] | Promiscuous sex[34] |
Clinical or biochemical evidence for chronic liver disease | Sharing intranasal cocaine equipment[12,33] | Poverty[34,35] |
Percutaneous exposures to HCV | History of sexually transmitted disease[12,33] with genital erosions[28] | History of invasive procedures[36] |
Haemophilia | Traumatic sex or vaginal sex during menstruation[14,33] | History of surgery[36] |
Children born to HCV + ve mothers | Health Care Workers performing procedures at risk of transmission to the patient[37] | Beauty treatments[38] |
HIV positivity | ||
Stable sexual partners of HCV + patients |
Table 3 Categories at risk for hepatitis B that should be screened and vaccinated
Immigrants from high prevalence areas (> 8% population) Asia, Pacific Islands, Alaska, Greenland, Africa, Middle East, former USSR, Eastern Europe (except Hungary), Malta, Amazonian areas of Peru, Brazil, Bolivia and Venezuela |
Refugees, adopted children, residents for more than 6 mo in the same areas |
Blood transfusion before 1973 |
Drug addicts |
Individuals with clinical or biochemical evidence for chronic liver disease |
Percutaneous exposures to HBV |
Haemophilia |
Pregnant women |
Haemodyalisis |
Household, sexual and needle sharing contacts of HBsAg patients |
Sexual partners of HBsAg patients |
Health Care Workers |
- Citation: Poggio PD, Mazzoleni M. Screening in liver disease. World J Gastroenterol 2006; 12(33): 5272-5280
- URL: https://www.wjgnet.com/1007-9327/full/v12/i33/5272.htm
- DOI: https://dx.doi.org/10.3748/wjg.v12.i33.5272