Who developed these recommendations?
The American College of Physicians (ACP) developed these recommendations with the Centers for Disease Control and Prevention (CDC). The ACP is a professional organization for internal medicine doctors, who specialize in health care for adults. The CDC is a U.S. government agency that promotes public health.
What is the problem and what is known about it so far?
Hepatitis B virus (HBV) infection spreads through contact with infected body fluids, such as by sexual contact, via contaminated needles, or from mother to baby at birth. Most people with HBV infection recover in a few months, but some develop chronic infection, permanent liver damage (cirrhosis), or liver cancer. Vaccination with a series of 3 shots over 6 months prevents HBV infection. Screening for HBV infection with a blood test identifies people with chronic infection who may benefit from earlier care, including drugs that decrease the chance of liver damage and screening for liver cancer.
How did the ACP and the CDC develop these recommendations?
The authors looked at guidelines from other organizations and studies related to best practices for HBV vaccination, screening, and linkage to care. They used this information to develop recommendations that the ACP and the CDC agreed would be best for patients.
What do the ACP and the CDC suggest that patients and doctors do?
The ACP and the CDC recommend HBV vaccination for people who request it and for unvaccinated adults (including pregnant women) at risk for infection, including:
• Sexual partners of people with HBV infection
• People who have many sex partners
• People with a history of sexually transmitted infections (STIs)
• Men who have sex with men
• Injection drug users
• People who live with someone who has HBV infection
• Health care and public safety workers who may come into contact with blood
• People with diseases that make their immune system weak, such as advanced kidney disease, chronic liver disease, or HIV
• People traveling to places with high rates of HBV infection
• People who work at or regularly visit jails, prisons, treatment facilities for STIs or drug abuse, day care centers for developmentally disabled people, or programs for end-stage kidney disease
The ACP and the CDC recommend screening for HBV in adults who are at risk, including people born in countries with high HBV infection rates, men who have sex with men, injection drug users, household or sexual contacts of HBV-infected people, users of drugs that suppress the immune system, people with end-stage kidney disease, blood and tissue donors, people infected with hepatitis C virus, people with persistently abnormal liver test results, and incarcerated populations. Pregnant women and infants born to infected women should be screened.
Doctors should speak with HBV-infected patients about possible treatment and care options. Patients should be referred to HBV-specific medical care and counseling programs. Not all patients with HBV infection need treatment.
Questions you may want to ask your doctor
• Should I get the HBV vaccine?
• How do I find out if I ever got the vaccine?
• Should I be screened for HBV?
• If I think I have been exposed to HBV, what should I do?
• If I have HBV infection, what are my treatment options and what can I do to prevent others from getting it?
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