People Born Outside of the United States and Viral Hepatitis

People born in any country with a medium-to-high prevalence of hepatitis B (>2%) should be tested for chronic hepatitis B.

Non-U.S.-born people account for 70% of all chronic hepatitis B infections in the United States. CDC recommends hepatitis B testing for:

  • People born in any country with medium-to-high prevalence of hepatitis B (>2%). This includes all countries in Asia, the Pacific Islands, and most African countries, especially countries in Sub-Saharan Africa.
  • People born in the United States who were not vaccinated at birth and have at least one parent born in a country with high prevalence of hepatitis B (>8%). This includes all countries in East and Southeast Asia (except for Japan), the Pacific Islands, and Sub-Saharan Africa.

CDC also recommends one-time hepatitis C testing of all adults (18 years and older) and regular testing for people with risk factors.

Asian Americans, Pacific Islanders, and People Born in Africa at Increased Risk for Hepatitis B

Many countries in Asia, the Pacific Islands, and Africa have high or moderate prevalence of chronic hepatitis B (see map below). The overall prevalence of hepatitis B in the WHO Western Pacific Region is about 6.2%, and nearly 70% of Asian Americans were born outside of the United States. Asian Americans make up 6% of the total population in the United States, but account for 58% of the 862,000 Americans living with chronic hepatitis B. Prevalence is also high among Pacific Islanders living in the United States. The overall prevalence of hepatitis B in the WHO African Region is 6.1%, although certain African countries are experiencing a much higher burden of infection (e.g., Somalia, Zimbabwe, Eritrea, Sudan, Nigeria, and Liberia). During the past 3 decades, migration from an African country of origin to the United States has increased from 200,000 to 1.7 million people. Of people living with chronic hepatitis B in the United States, 12% were born in Africa.

CDC has developed resources, such as fact sheets and community mobilization toolkits, to help educate people born in these countries about the importance of hepatitis B testing.

Photo: Worldwide Rates of Chronic Hepatitis B Map

For additional information on other groups that should be tested for hepatitis B, see: Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection pdf icon[PDF – 28 pages]

Scientific Guidelines and Recommendations

Chronic Hepatitis B Testing

Hepatitis B Vaccination

Health-care Provider Resources

Patient Resources