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Viral Hepatitis and Liver Disease

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Pre-Vaccination Testing for Hepatitis B

for Health Care Providers

When and How to Perform Pre-Vaccination Testing - Hepatitis B

Which test to use: If testing is needed prior to vaccination, use HBsAg, HBsAb, HBcAb Total

  • Pre-vaccination testing should be performed if there is a reasonable chance the patient has previously been infected with HBV or vaccinated for HBV
  • Pre-vaccination testing is not always necessary but should be performed for some patient groups:
    • Household, sexual, or needle contacts of hepatitis B surface antigen (HBsAg)-positive persons
    • HIV-positive persons
    • Persons with elevated alanine aminotransferase/aspartate aminotransferase of unknown etiology
    • Hemodialysis patients
    • Men who have sex with men
    • Past or current persons who inject drugs
    • Persons born in countries of high and intermediate hepatitis B virus (HBV) endemicity (HBsAg prevalence ≥2%)
    • U.S.-born persons not vaccinated as infants whose parents were born in countries with high HBV endemicity (≥8%)
    • Persons needing immunosuppressive therapy, including chemotherapy, immunosuppression related to organ transplantation, and immunosuppression for rheumatologic or gastroenterologic disorders
    • Donors of blood, plasma, organs, tissues, or semen