Clinical Summary

Hepatitis B Virus Infection in Adolescents and Adults: Screening

December 15, 2020

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

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Panel 1
What does the USPSTF recommend?

For adolescents and adults:
Screen adolescents and adults at increased risk for hepatitis B virus (HBV) infection. Grade B
To whom does this recommendation apply? All asymptomatic, nonpregnant adolescents and adults at increased risk for HBV infection, including those who were vaccinated before being screened for HBV infection.
What's new? This recommendation is consistent with the 2014 USPSTF recommendation. It is strengthened by new evidence that treatment of HBV infection consistently leads to better health outcomes.
How to implement this recommendation? Screen. Screen adolescents and adults at increased risk using hepatitis B surface antigen (HbsAg) tests followed by a confirmatory test for initially reactive results. 

Important risk groups for HBV infection with a prevalence of ≥2% that should be screened include:

  • Persons born in countries and regions with a high prevalence of HBV infection (≥2%), such as Asia, Africa, the Pacific Islands, and parts of South America
  • US-born persons not vaccinated as infants whose parents were born in regions with a very high prevalence of HBV infection (≥8%)
  • HIV-positive persons
  • Persons with injection drug use
  • Men who have sex with men
  • Household contacts or sexual partners of persons with HBV infection

For more information on countries and regions with a high prevalence of HBV infection, visit: https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/hepatitis-b#5182
How often? Periodically screen persons with continued risk for HBV infection (eg, persons with current injection drug use, men who have sex with men).
What are other relevant USPSTF recommendations? The USPSTF has made recommendations on screening for HBV infection in pregnant persons, hepatitis C virus infection in adolescents and adults, and HIV infection. These recommendations are available at www.uspreventiveservicestaskforce.org/.
Where to read the full recommendation statement? Visit the USPSTF website to read the full recommendation statement. This includes more details on the rationale of the recommendation, including benefits and harms; supporting evidence; and recommendations of others.