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)

Two-page Summary Table: Recommendations for Routine Testing and Vaccination for Chronic Hepatitis B virus (HBV) Infection Color [PDF – 1 page] Black-White [PDF – 1 page]

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

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

Patient Education Tools

Serology

Interpretation of Hepatitis B Serologic Test Results – Table [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 Guidelines
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 Trials
National, nonprofit organization dedicated to persons whose lives are affected by Hepatitis B