title: Hepatitis B screening in US travelers seen at the Boston area travel medicine network.
abstract: BACKGROUND
  Persons born in countries with hepatitis B surface antigen (HBsAg) prevalence ≥2% have increased risk for unrecognized hepatitis B virus (HBV) infection. Testing at pre-travel consultations is a strategy to identify previously undiagnosed HBV infections. Using records of travelers seen at the Boston Area Travel Medicine Network (BATMN) sites, we assessed how these travel clinics currently assess HBV status, describe test results, and describe characteristics of those tested and immunized for HBV.
  
  
  METHODS
  Demographic data and trip information were collected for all travelers seen at the BATMN sites from June 2008 through July 2010. Proportions of those tested for HBV were determined, and differences between those tested and not tested were analyzed.
  
  
  RESULTS
  Among 13,732 travelers enrolled during the study period, 2,134 (16%) were born in HBV-risk countries (HBsAg prevalence ≥2%); 532/2134 (25%) had previous HBV test results and 230 (11%) had tests performed at the travel clinic visit. Past results showed that 33/453 (7.3%) were HBV-infected (HBsAg+), 252/481 (52.4%) were immune (anti-HBs+, HBsAg-), 164/303 (54.1%) were susceptible (anti-HBs-, HBsAg-, anti-HBc-), and 38/314 (12.1%) had possible HBV exposure (anti-HBc+, HBsAg-, anti-HBs-). Among 230 travelers tested during the travel clinic visit, 7/213 (3.3%) were HBV-infected, 95/218 (43.6%) were immune, 106/179 (59.2%) were susceptible, and 10/182 (5.5%) had possible HBV exposure.
  
  
  CONCLUSIONS
  The travel clinic offers an opportunity to capture, identify, and educate infected persons unaware of their infection, educate those with known results, and initiate preventive action (eg, vaccination) for those still susceptible.
authors.affiliation: Travel Medicine Center, Mount Auburn Hospital, Cambridge, MA, USA. lchen@hms.harvard.edu
authors.forename: Lin H
authors.initials: LH
authors.lastname: Chen
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Barnett
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wilson
authors.forename: William
authors.initials: W
authors.lastname: Macleod
authors.forename: Emad A
authors.initials: EA
authors.lastname: Yanni
authors.forename: Winnie
authors.initials: W
authors.lastname: Ooi
authors.forename: Adolf W
authors.initials: AW
authors.lastname: Karchmer
authors.forename: Laura
authors.initials: L
authors.lastname: Kogelman
authors.forename: Nina
authors.initials: N
authors.lastname: Marano
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
mesh_terms: D000328:Adult; D001900:Boston / Q000453:epidemiology; D003253:Consultants / Q000706:statistics & numerical data; D003906:Developing Countries; D003951:Diagnostic Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D038622:Internationality; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D012698:Serologic Tests / Q000379:methods*; D014195:Travel / Q000706:statistics & numerical data; D057236:Travel Medicine / Q000379:methods / Q000458:organization & administration; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens