Recommended Tests to Screen for Chronic Hepatitis B
What HBV tests should you order?
HBsAg Test
anti-HBs Test
Hepatitis B surface antigen (p.7)
Hepatitis B surface antibody (p.7)
What do the HBV test results mean?
HBsAg Negative
HBsAg Negative
anti-HBs Positive
anti-HBs Negative
HBsAg Positive
Chronic HBV infection* *If HBsAg remains positive for 6 months apart or in the absence of IgM anti-HBc.
Immunity
Unprotected
Your patient is protected from HBV
Vaccinate (p.9-12): 3 shots over 6 months
1. Protect your patient (p.14)
Why test for chronic HBV?
Give the hepatitis A vaccine Tell your patient to avoid alcohol Test and vaccinate close contacts
2 out of 3 persons in the U.S. living with chronic hepatitis B are unaware that they are infected.
2. Screen for liver cancer (p.16) AFP - Every 6 months Ultrasound - Every 6-12 months
Who should you test for chronic HBV? (p.8)
3. Monitor for liver damage (p.15) ALT - Every 6 months
4. Baseline HBeAg and HBV DNA level (p.15)
See p. 17 for indications for treatment or referral for treatments.
All pregnant women
Persons born in countries with high and intermediate HBV endemicity (HBsAg prevalence * 2%)
US born persons not vaccinated as infants whose parents were born in countries with high HBV endemicity (
For additional information on who to test, go to: www.cdc.gov/hepatitis/HBV/testingchronic.htm
Recommendations are abridged from the Morbidity and Mortality Weekly Report (MMWR), published by the U.S. Centers for Disease Control and Prevention (CDC),1 and the 2009 practice guidelines released by the American Association for the Study of Liver Diseases.2 2