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Viral Hepatitis and Liver Disease

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Who to Screen for Hepatitis B

for Health Care Providers

Who to Screen for Current or Prior Infection - Hepatitis B

The following populations are considered at high risk of hepatitis B virus (HBV) infection.

Which tests to use: Screen for current or prior infection with HBsAg, HBsAb, HBcAb Total

  • Anyone born in or traveling to a region of intermediate to high HBV prevalence (>2%)
    • Africa (all countries)
    • Asia: North Asia, Southeast Asia, and East Asia (all countries)
    • South Pacific (all countries except Australia and New Zealand)
    • Middle East (all countries except Cyprus and Israel)
    • Eastern Europe (all countries except Hungary)
    • Malta and Spain
    • Indigenous populations of Greenland
    • Alaskan natives
    • Indigenous populations of Northern Canada
    • Mexico, Guatemala, and Honduras
    • South America (Ecuador, Guyana, Suriname, Venezuela, and Amazonian areas)
    • Caribbean (Antigua-Barbuda, Dominica, Grenada, Haiti, Jamaica, Saint Kitts and Nevis, Saint Lucia, and Turks and Caicos Islands)
  • U.S.-born individuals not vaccinated as infants whose parents were born in regions with high HBV prevalence (>8%)
  • Persons at risk for HBV infection by sexual exposure
    • Men who have sex with men
    • Persons with multiple sex partners
    • Persons seeking evaluation or treatment for an STD
    • Sex partners of HBSAg+ persons
  • Persons at risk for HBV infection by percutaneous or mucosal exposure to blood
    • Anyone who has ever injected drugs
    • Household and needle-sharing contacts of HBsAg-positive persons
    • Residents and staff of facilities for developmentally disabled persons
    • Health care and public safety workers at risk for occupational exposure to blood or blood-contaminated body ?uids
    • Persons with end-stage renal disease, including pre-dialysis or any form of dialysis
    • Persons who are the source of blood or body fluid exposures(e.g., needlestick, sexual assault) that might require post-exposure prophylaxis
  • Persons at risk for vertical transmission of HBV
    • All pregnant women
    • Infants born to HBsAg-positive mothers
  • Persons with chronic liver disease
    • Persons with chronic liver disease including HCV, cirrhosis, fatty liver disease, alcoholic liver disease, and autoimmune hepatitis
    • Individuals with elevated ALT or AST of unknown etiology
  • Persons who are immunosuppressed
    • Persons with HIV
    • Persons needing immunosuppressive therapy including
      • chemotherapy
      • immunosuppression related to organ transplantation
      • immunosuppression for rheumatological or gastroenterologic disorders
  • Other
    • Donors of blood, plasma, organs, tissues, or semen
    • Inmates of correctional facilities
    • Unvaccinated persons with diabetes who are aged 19 through 59 years (clinician's discretion for unvaccinated adults with diabetes who are 60 or older)