Performance Measure: Hepatitis B Screening

National Quality Forum #: None

Description: Percentage of patients, regardless of age, for whom Hepatitis B screening¹ was performed at least once since the diagnosis of HIV/AIDS or for whom there is documented infection² or immunity³

Numerator: Number of patients for whom Hepatitis B screening was performed at least once since the diagnosis of HIV or for whom there is documented infection² or immunity³

Denominator: Number of patients, regardless of age, with a diagnosis of HIV and who had at least two medical visits during the measurement year, with at least 60 days in between each visit

Patient Exclusions: None

Data Elements:

1. Does the patient, regardless of age, have a diagnosis of HIV? (Y/N)
   
   1. If yes, did the patient have at least two medical visits during the measurement year, with at least 60 days in between each visit?(Y/N)
      
      1. If yes, is there evidence of documented Hepatitis B infection² or immunity³ in the patient medical record? (Y/N)
         1. If no, was Hepatitis B screening performed at least once since diagnosis of HIV infection? (Y/N)
            
            1. If yes, list date

Comparison data

The HIV Quality Measures (HIVQM) Module is a tool within the Ryan White HIV/AIDS Services Report portal. It allows recipients to enter aggregate data specific to HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.

Department of Health and Human Services Clinical Practice Guidelines

"All patients with HIV infection should be screened for Hepatitis B, and screening should include HBsAg, anti-HBs and anti-HBc."⁴

"In acute infection, HBsAg can be detected 4 weeks (range 1-9 weeks) after exposure and anti-HBc immunoglobulin M is usually detectable at the onset of symptoms."⁵

Use in other federal programs

None

References/notes

¹ Screening can be completed in two ways: 1) Test for Hepatitis B surface antibody (anti-HBs) and if negative, proceed to Hepatitis B surface antigen (HBsAg) and Hepatitis B core antibody total (anti-HBc); or 2) complete all three tests at once.

² Documented infection includes any patient with active or chronic Hepatitis B infection.

³ Documented immunity includes patient's immunity to Hepatitis B due to natural infection or Hepatitis B vaccination. Interpretations for Hepatitis B serologic markers are available at Hepatitis B Questions and Answers for Health Professionals.

⁴ Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed August 2023. L-3.

⁵ Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed August 2023. L-1.