Testing and Public Health Management of Persons with Chronic Hepatitis B Virus Infection

On September 19, 2008, CDC published updated and expanded guidelines for testing for chronic Hepatitis B virus (HBV) infection and recommendations for public health evaluation and management for chronically infected persons and their contacts. Serologic testing for Hepatitis B surface antigen (HBsAg) is the primary way to identify persons chronic HBV infection.

Testing for HBsAg now is recommended for:

  • persons born in geographic regions with HBsAg prevalence of 2%
  • US born persons not vaccinated as infants whose parents were born in geographic regions with HBsAg prevalence of ≥8%
  • injection-drug users
  • men who have sex with men
  • persons with elevated ALT/AST of unknown etiology
  • persons with selected medical conditions who require immunosuppressive therapy

Testing continues to be recommended for:

  • pregnant women
  • infants born to HBsAg-positive mothers
  • household contacts and sex partners of HBV-infected persons
  • persons who are the source of blood or body fluid exposures that might warrant postexposure prophylaxis (e.g., needlestick injury to a health care worker)
  • persons infected with HIV

Guidelines and Recommendations

Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection, MMWR 2008;57(RR-8)

Recommendations for Routine Testing and Vaccination for Chronic Hepatitis B virus (HBV) Infection
Printable document pdf icon[PDF – 2 page]

Related Map: Geographic Distribution of Chronic Hepatitis B virus (HBV) Infection — Worldwide, 2006 pdf icon[PDF – 1 page]

Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice From the American College of Physicians and CDCexternal icon

Patient Education Tools

Title English Other Languages
Patient Education Tools
General Information
Hepatitis B – General Fact Sheet
PDFpdf icon Spanishpdf icon
Chronic Hepatitis B
Hepatitis B – Are You at Risk?
PDFpdf icon Chinesepdf icon
When Someone Close to You has Hepatitis B
PDFpdf icon Chinesepdf icon


Interpretation of Hepatitis B Serologic Test Results – Table pdf icon[PDF – 1 page]

Online Serology Training – Hepatitis A–E

Clinical Guidelines

Identification and Management of Hepatitis B Surface Antigen (HBsAg)–Positive Persons
Guidance for vaccination providers on identification and management of persons with chronic HBV infection, MMWR 2006,55(RR-16), Appendix C

AASLD Practice Guidelinesexternal icon
American Association for the Study of Liver Diseases

CDC guidance on the treatment of sexually transmitted diseases, including Hepatitis B

Specific Sites and Tools

Hepatitis B Foundation – Clinical Trialsexternal icon
National, nonprofit organization dedicated to persons whose lives are affected by Hepatitis B