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Clinical Summary

Hepatitis B Virus Infection: Screening, 2014

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.

Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults: Clinical Summary of USPSTF Recommendation, 2014

Population Asymptomatic, nonpregnant adolescents and adults at high risk for hepatitis B virus (HBV) infection (including those at high risk who were vaccinated before being screened for HBV infection).
Recommendation Screen persons at high risk for HBV infection.
Grade: B
Risk Assessment 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%)
  • U.S.-born persons not vaccinated as infants whose parents were born in regions with a very high prevalence of HBV infection (≥8%), such as sub-Saharan Africa and southeast and central Asia
  • HIV-positive persons
  • Injection drug users
  • 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:

Screening Tests A U.S. Food and Drug Administration–approved hepatitis B surface antigen (HBsAg) test followed by a licensed, neutralizing confirmatory test for initially reactive results should be used to screen for HBV. Testing for antibodies to HBsAg (anti-HBs) and hepatitis B core antigen (anti-HBc) is also done as part of a screening panel to help distinguish between infection and immunity.

Diagnosis of chronic HBV infection is characterized by persistence of HBsAg for at least 6 mo.

Treatment HBV treatment consists of antiviral regimens. Approved first-line treatments are pegylated interferon α2a, entecavir, and tenofovir. Duration of treatment varies depending on time required to achieve HBV DNA suppression and normalize alanine aminotransferase levels; the presence of HBeAg, coinfection, and cirrhosis; and the choice of drug.
Balance of Benefits and Harms There is moderate certainty that screening for HBV infection in persons at high risk for infection has moderate net benefit.
Other Relevant USPSTF Recommendations The USPSTF has made recommendations on screening for HBV infection in pregnant women and screening for hepatitis C virus infection in adults. These recommendations are available at

For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to

Current as of: June 2014

Internet Citation: Clinical Summary: Hepatitis B Virus Infection: Screening, 2014. U.S. Preventive Services Task Force. October 2014.

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