From the Guidelines
You should undergo Hepatitis B (HBV) screening if you are at high risk, such as having multiple sex partners, being a healthcare worker, or having a family history of the disease, as recommended by the Centers for Disease Control and Prevention 1.
Key Risk Groups
The following groups are considered high risk and should be screened for HBV:
- Persons born in countries and regions with a high prevalence of HBV infection (≥ 2%) 1
- U.S.-born persons not vaccinated as infants whose parents were born in regions with a very high prevalence of HBV infection (≥ 8%) 1
- HIV-positive persons 1
- Persons with injection drug use 1
- Men who have sex with men 1
- Household contacts or sex partners of persons with HBV infection 1
Screening Intervals
The screening test is typically a blood test that checks for the presence of the Hepatitis B surface antigen (HBsAg) and can be done at any time, but it's usually recommended at the following intervals:
- Newborns: at birth
- Infants: 1-2 months and 6-12 months after birth if the mother is infected
- Children: 6-12 months after completion of the Hepatitis B vaccine series
- Adults: at least once if you are at high risk, and annually if you have HIV 1 It's also recommended to get vaccinated against Hepatitis B if you are at high risk and have not been previously vaccinated, with a series of 2-3 doses over 6 months, and a booster dose at 1 year 1.
Additional Recommendations
The CDC recommends continued periodic testing while the exposure persists, and individuals who meet criteria for treatment of HBV based on current clinical practice guidelines should receive antiviral therapy regardless of their risk of HBV reactivation 1.
From the Research
Hepatitis B Screening Recommendations
The following groups are recommended to undergo Hepatitis B (HBV) screening:
- Pregnant women 2, 3, 4
- Adolescents and all adults at high risk of chronic infection 2
- Persons born in countries with 2% or higher HBV prevalence 3
- Men who have sex with men 3
- Persons who inject drugs 3
- HIV-positive persons 3
- Household and sexual contacts of HBV-infected persons 3
- Persons requiring immunosuppressive therapy 3
- Persons with end-stage renal disease (including hemodialysis patients) 3, 5
- Blood and tissue donors 3
- Persons infected with hepatitis C virus 3
- Persons with elevated alanine aminotransferase levels (≥19 IU/L for women and ≥30 IU/L for men) 3
- Incarcerated persons 3
- Infants born to HBV-infected mothers 3, 4
- Adults with chronic liver disease 3
- Travelers to HBV-endemic regions 3
- Adults seeking protection from HBV infection 3
Screening Tests
HBV screening typically starts with:
- HBsAg (hepatitis B surface antigen) testing
- HBsAb (antibody to hepatitis B surface antigen) testing
- Total anti-HBc (total antibody to hepatitis B core antigen) testing 4
Barriers to Screening
Common barriers to HBV screening include:
- Cost 6
- Time constraints 6
- Lack of knowledge 6
- Perception that screening is someone else's responsibility 6
Importance of Screening and Vaccination
HBV screening and vaccination are crucial in preventing HBV infection and its complications, such as chronic liver disease and hepatocellular carcinoma 2, 3, 5. The HBV vaccine is 95% effective in preventing infection and the development of chronic liver disease and hepatocellular carcinoma due to hepatitis B 5.