Viral Hepatitis Testing and Notification After Exposure
Bloodborne Pathogens Testing Guidance
Depending upon the risk of transmission, there may be recommendations for bloodborne pathogen screening as part of the notification process. CDC staff are always available for consultation including discussion of testing algorithms for specific notification settings.
It may take six months or more for recent infections to be serologically detectable. To identify all potential infections, the clinician should re-test after six months has passed from last exposure.
Suggested tests may vary according to the recency and likelihood of exposure and typically include:
- Serologic testing for hepatitis C antibody (anti-HCV) and if positive reflex to HCV RNA testing [PDF – 4 pages] (which may require an additional frozen serum specimen),
- Serologic testing for hepatitis B surface antigen (HBsAg) (may also consider total antibody to hepatitis B core antigen (total anti-HBc) and antibody to hepatitis B surface antigen (Anti-HBs) tests to determine past infection and immunity status). Note: In March 2023 CDC published updated recommendations for hepatitis B screening and testing that include a universal one-time hepatitis screen for all persons with a test for HBsAg, anti-HBs and total anti-HBc.
This patient notification toolkit provides a communications framework for state and local health departments to use for public notification as part of public health response to possible bloodborne pathogen exposures in a variety of health care settings.
- Algorithm for testing and follow-up of HCV-exposed health care personnel [PDF – 177 KB]
- Hepatitis Exposure Management UCSF, Postexposure management after distinct nonoccupational percutaneous or mucosal exposure to blood or body fluids from Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, MMWR 2018;67(1).
- Interpretation of Hepatitis B Serologic Test Results (cdc.gov).
- Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023, MMWR Recomm Rep 2023;72(No. RR-1):1–25.
- HIV testing resources