CDC, ACP Offer Joint Guidance on Hepatitis B Vaccination and Screening

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

The CDC and the American College of Physicians have released best practice advice on vaccinating against and screening for hepatitis B virus (HBV).

The document, published in Annals of Internal Medicine, recommends vaccinating the following at-risk adults:

• Patients at risk from sexual exposure — e.g., people whose partners are positive for hepatitis B surface antigen (HBsAg), sexually active people who are not in a monogamous relationship, patients who are being seen for a possible sexually transmitted infection, and men who have sex with men

• Those at risk from mucosal or percutaneous exposure to blood — e.g., injection drug users, healthcare workers

• Patients with chronic liver disease, end-stage renal disease, or HIV

• Pregnant patients who have high-risk sexual activity or drug use

• People who travel to countries where HBV infection is endemic

Clinicians should screen the following at-risk groups for hepatitis B infection:

• People born in countries with an HBV prevalence of 2% or above

• Men who have sex with men

• Injection drug users

• Patients with HIV or end-stage renal disease

• Household and sexual contacts of patients with HBV

• Blood and tissue donors

• Pregnant women

• People with hepatitis C or those who have elevated alanine aminotransferase levels

• Incarcerated people

• Infants born to HBV-infected mothers

Patients who test positive for HBsAg should be provided counseling and HBV-directed care.