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. 2023 Mar 10;72(1):1-25.
doi: 10.15585/mmwr.rr7201a1.

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023

Erin E Conners  1 , Lakshmi Panagiotakopoulos  1 , Megan G Hofmeister  1 , Philip R Spradling  1 , Liesl M Hagan  1 , Aaron M Harris  1 , Jessica S Rogers-Brown  1 , Carolyn Wester  1 , Noele P Nelson  1 ; Contributors
Collaborators, Affiliations

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023

Erin E Conners et al. MMWR Recomm Rep. .

Abstract

Chronic hepatitis B virus (HBV) infection can lead to substantial morbidity and mortality. Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality. Effective vaccines to prevent hepatitis B are available. This report updates and expands CDC's previously published Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection (MMWR Recomm Rep 2008;57[No. RR-8]) regarding screening for HBV infection in the United States. New recommendations include hepatitis B screening using three laboratory tests at least once during a lifetime for adults aged ≥18 years. The report also expands risk-based testing recommendations to include the following populations, activities, exposures, or conditions associated with increased risk for HBV infection: persons incarcerated or formerly incarcerated in a jail, prison, or other detention setting; persons with a history of sexually transmitted infections or multiple sex partners; and persons with a history of hepatitis C virus infection. In addition, to provide increased access to testing, anyone who requests HBV testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks.

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were reported.

Figures

FIGURE 1
FIGURE 1
Typical serologic courses of acute and chronic hepatitis B virus infection Source: Adapted from Weinbaum CM, Williams I, Mast EE, et al.; CDC. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR Recomm Rep 2008;57(No. RR-8):1–20. Abbreviations: anti-HBc = antibody to hepatitis B core antigen; anti-HBe = antibody to hepatitis B e antigen; anti-HBs = antibody to hepatitis B surface antigen; HBeAg = hepatitis B e antigen; HBsAg = hepatitis B surface antigen; HBV = hepatitis B virus; IgM = immunoglobulin M.
FIGURE 2
FIGURE 2
Incorporating hepatitis B virus screening and testing into a clinic workflow, by age Abbreviations: ACIP = Advisory Committee on Immunization Practices; anti-HBc = antibody to hepatitis B core antigen; anti-HBs = antibody to hepatitis B surface antigen; HBV = hepatitis B virus; HBsAg = hepatitis B surface antigen; HepB = hepatitis B.
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