Open for Comment: Draft USPSTF Research Plan on HBV Screening

The U.S. Preventive Services Task Force recently posted a draft research plan on screening for hepatitis B virus infection in nonpregnant adolescents and adults. The draft research plan is available for review and public comment through January 2, 2019. To review the draft research plan and submit comments, visit this page on the USPSTF site.

The final Research Plan will be used to guide a systematic review of the evidence. The resulting Evidence Review will form the basis of the USPSTF Recommendation Statement on this topic.

The draft research plan proposes the following key questions to be systematically reviewed:

1. What are the benefits of screening for hepatitis B virus (HBV) infection in asymptomatic, nonpregnant adolescents and adults on morbidity, mortality, and disease transmission?
2. What are the harms of screening for HBV infection (e.g., labeling, anxiety, and harms of confirmatory tests, including biopsy)?
3. What is the yield (number of new diagnoses per tests performed) and sensitivity of alternative HBV screening strategies (e.g., universal vs. targeted screening, or screening strategies based on alternative risk factors)?
4. How effective is antiviral treatment at improving intermediate outcomes in nonpregnant adolescents and adults with chronic HBV infection, including virologic or histologic improvement, clearance of hepatitis B e-antigen (HBeAg) (as indicated by loss of HBeAg or acquisition of antibody to HBeAg [anti-HBe]), or clearance of hepatitis B surface antigen (HBsAg) (as indicated by loss of HBsAg or acquisition of hepatitis B surface antibody [anti-HBs])?*
5. How effective is antiviral treatment at improving health outcomes in nonpregnant adolescents and adults with chronic HBV infection?*
6. What are the harms associated with antiviral treatment of chronic HBV infection in nonpregnant adolescents and adults?*
7. What is the association between improvements in intermediate outcomes as a result of antiviral treatment of chronic HBV infection and reduction in risk of HBV-related adverse health outcomes?

* Subpopulations of interest for Key Questions 4, 5, and 6 include those defined by age, race/ethnicity, sex, HBV genotype, HBeAg status, fibrosis stage, alanine transaminase level, and HBV deoxyribonucleic acid (DNA) level.

The draft also includes proposed contextual questions and a proposed research approach. USPSTF welcomes stakeholder feedback on all of these elements.

Comments on the draft plan are due by Wednesday, January 2, 2019. To review the draft research plan and submit comments, visit https://www.uspreventiveservicestaskforce.org/Page/Document/draft-research-plan/hepatitis-b-virus-infection-screening-nonpregnant

Working to improve the health of all Americans, the USPSTF is an independent panel of non-Federal experts that makes recommendations on clinical preventive services, such as screenings, counseling, and preventive medications, to primary care clinicians. The USPSTF bases its recommendations on a rigorous, systematic review of peer-reviewed evidence, critique by subject matter experts, and public comment. The Agency for Healthcare Research and Quality (AHRQ), part of the U.S. Department of Health and Human Services, has been authorized by the U.S. Congress to convene the Task Force and to provide ongoing scientific, administrative, and dissemination support to the Task Force.