Identification of chronic hepatitis B
Authors: Shih-Wei Lai, Kuan-Fu Liao
Journal: Journal of Hepatology (2013)

Identification and treatment of chronic hepatitis B in Chinese migrants: Results of a project offering on-site testing in Rotterdam, The NetherlandsJournal of HepatologyVol. 57Issue 6PreviewMigrants born in countries where hepatitis B is endemic are a risk group for chronic hepatitis B virus (HBV) infection. Treatment options have improved, but due to the asymptomatic nature of chronic HBV infection, the majority of patients remain unidentified. Full-Text PDF Reply to: “Identification of chronic hepatitis B”Journal of HepatologyVol. 58Issue 5PreviewWe appreciate the letter to the editor regarding our paper on the results of a project offering on-site hepatitis B testing to Chinese migrants in Rotterdam [1]. To take Lai and Liao’s suggestion to screen persons born in Taiwan before 1986 further, we would like to recommend offering screening to all persons born in hepatitis B endemic countries before the introduction of universal vaccination. Full-Text PDF Open Access One paper with impressive findings recently published in The Journal of Hepatology by Veldhuijzen et al., reported that on-site testing could increase the detecting rate of hepatitis B for high-risk persons [[1]Veldhuijzen I.K. Wolter R. Rijckborst V. Mostert M. Voeten H.A. Cheung Y. et al.Identification and treatment of chronic hepatitis B in Chinese migrants: results of a project offering on-site testing in Rotterdam.The Netherlands J Hepatol. 2012; 57: 1171-1176Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar]. We would like to comment that Veldhuijzen et al.’s paper highlights the concept that only those who know they are infected with hepatitis B could have the chance to receive antiviral treatment. Likewise, Hsu et al.’s study showed that using electronic health records among primary care providers could significantly increase the screening rate of hepatitis B for high-risk persons [[2]Hsu L. Bowlus C.L. Stewart S.L. Nguyen T.T. Dang J. Chan B. et al.Electronic messages increase Hepatitis B screening in at-risk Asian American patients: a randomized, controlled trial.Dig Dis Sci. 2012; ([online paper]): 1-8PubMed Google Scholar]. Li et al. reported that those having a family physician and having better knowledge of hepatitis B could be associated with increased screening rates of hepatitis B [[3]Li D. Tang T. Patterson M. Ho M. Heathcote J. Shah H. The impact of hepatitis B knowledge and stigma on screening in Canadian Chinese persons.Can J Gastroenterol. 2012; 26: 597-602PubMed Google Scholar]. These studies provide valuable evidence that hepatitis B screening recommended by primary care providers could increase the detecting rate of hepatitis B. Taiwan is the first country in the world to a commence national hepatitis B immunization program for newborns. Initially, hepatitis B vaccine was only given to newborns whose mothers were hepatitis B carriers since July 1984. Two years later, universal immunization has been extended to all newborns from 1986 to date [[4]Huang K. Lin S. Nationwide vaccination: a success story in Taiwan.Vaccine. 2000; 18: S35-S38Crossref PubMed Scopus (124) Google Scholar]. Since the prevalence of hepatitis B carriers was around 14.7–19.5% in Taiwan before universal immunization [5Wu J.S. Chen C.H. Chiang Y.H. Lee Y.C. Lee M.H. Ko Y.C. et al.Hepatitis B virus infection in Taiwan with reference to anti-HBc versus HBsAg and anti-HBs.Taiwan Yi Xue Hui Za Zhi. 1980; 79: 760-767PubMed Google Scholar, 6Lai S.W. Lin T. Liao K.F. Lai H.C. Liu C.S. Lin C.C. Seroepidemiology of hepatitis B and hepatitis C virus infections in people receiving health checkups – a hospital-based study.Ann Acad Med Singapore. 2009; 38: 1106PubMed Google Scholar], and the current CDC guidelines already recommend screening of all subjects born in countries with hepatitis B prevalence ⩾2% [[7]Centers for Disease Control and Prevention. Hepatitis B Information for Health Professionals. http://www.cdc.gov/hepatitis/Settings/index.htm [cited in 2012 November].Google Scholar], based on cost-benefit effect, we would like to suggest that migrants who were born in Taiwan before 1986 should be recommended for hepatitis B screening. The authors declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.