Hepatitis B Diagnostic Chart Outline

Hepatitis B Screening and Vaccination Algorithm for Newly Arrived Refugees in the United States

Top of chart begins: “Hepatitis B Surface Antigen (HBsAg)”

  1. If “Positive”, then Q: “Chronic or active infection?”, then Q: “Clinical evidence of chronic or acute infection or epidemiologic link to identified case?”
    1. If “No”, then “Chronic Infection”, then “Counseling, ongoing monitoring, and treatment, if indicated. Evaluate and vaccinate close contacts, if necessary.”
    2. If “Yes”, then “IgM anti-HBc”
      1. If “Negative”, then “Chronic Infection”, then “Counseling, ongoing monitoring, and treatment, if indicated. Evaluate and vaccinate close contacts, if necessary.”
      2. If “Positive”, then “Clinical evidence of acute infection.”, then “Counseling, ongoing monitoring, and treatment, if indicated. Evaluate and vaccinate close contacts, if necessary.”
  2. If “Negative”, then “No active infection”, then Q: “Anti-HBs?”
    1. If “Positive”, then Q: “Previous dose(s) of Hepatitis B vaccine?”
      1. If “Yes”, then Q: “Completed series according to ACIP?”
        1. If “Yes”, then “No vaccines needed.”
        2. If “No”, then “Complete vaccine series according to ACIP schedule”
      2. If “No”, then Q: “Total anti-HBc?”
        1. If “Negative”, then “Complete vaccine series according to ACIP schedule”
        2. If “Positive”, then “Immune due to past infection. No vaccination needed.”
    2. If “Negative”, then “Offer vaccine or complete series according to ACIP schedule.”