Can Men Get Checked for Blood-Borne Viruses?
Yes, men can and should get checked for blood-borne viruses (BBV), particularly if they belong to high-risk groups, with screening recommendations specifically including men who have sex with men, injection drug users, and those with other risk factors for HBV, HCV, and HIV infection. 1
Who Should Be Screened
Men should be screened for BBV if they fall into any of these high-risk categories:
- Men who have sex with men - explicitly identified as a high-risk group requiring screening for HBV, HCV, and HIV 1
- Injection drug users (current or past) - at increased risk for all three major blood-borne viruses 1
- Men born in high-prevalence regions - those from countries with HBsAg prevalence ≥2% (Asia, Africa, Pacific Islands, parts of South America) 1
- Men with multiple sexual partners or history of sexually transmitted infections 1
- HIV-positive men - should be screened for HBV and HCV 1
- Sexual partners of HBV-infected persons 1
- Healthcare workers with occupational blood exposure 1
- Hemodialysis patients 1
What Tests Should Be Performed
The screening panel varies by virus but typically includes:
- For HBV: Hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs), followed by confirmatory testing for initially reactive results 1
- For HCV: Anti-HCV antibody testing, with confirmatory supplemental tests for repeatedly reactive results 1
- For HIV: HIV antibody testing, with rapid testing options available 1, 2
Screening Intervals
For men with ongoing risk factors (such as those who continue to inject drugs or men who have sex with men), periodic screening should be performed rather than one-time testing 1. The specific interval should be based on continued risk behaviors.
Important Considerations
The 2014 USPSTF guidelines represent a significant shift from the 2004 recommendation that advised against screening the general population 1. The current evidence supports targeted screening of high-risk groups because:
- Antiviral regimens now demonstrably improve health outcomes, including reduced incidence of hepatocellular carcinoma 1
- HBV vaccination is effective at decreasing disease acquisition in high-risk populations 1
- Early identification allows for timely intervention and prevention of transmission 1
Common pitfall to avoid: Do not assume that screening is only for pregnant women or healthcare workers after occupational exposure. Men in high-risk groups benefit from proactive screening regardless of symptoms or known exposure 1.
The CDC and American Association for the Study of Liver Diseases both strongly endorse screening for men in these high-risk categories, emphasizing that undiagnosed infection leads to ongoing transmission and progression to cirrhosis and hepatocellular carcinoma 1.