Screening
ÎTesting for HBsAg and anti-HBs should be performed on groups at high risk for HBV infection (Table 2), and seronegative persons should be vaccinated. (I)
Table 2. High Risk Groups Individuals born in areas of higha
including immigrants and adopted childrenc,d Asia: All countries Africa: All countries South Pacific Islands: All countries Middle East (except Cyprus and Israel) European Mediterranean: Malta and Spain The Arctic (Indigenous populations of Alaska, Canada, and Greenland)
or intermediate prevalence ratesb for HBV
South America: Ecuador, Guyana, Suriname, Venezuela, and Amazon regions of Bolivia, Brazil, Colombia, and Peru Eastern Europe: All countries except Hungary
Caribbean: Antigua and Barbuda, Dominica, Granada, Haiti, Jamaica, St. Kitts and Nevis, St. Lucia, and Turks and Caicos.
Central America: Guatemala and Honduras Other groups recommended for screening
U.S. born persons not vaccinated as infants whose parents were born in regions with high HBV endemicity (≥ 8%) Household and sexual contacts of HBsAg-positive personsd Persons who have ever injected drugsd Persons with multiple sexual partners or history of sexually transmitted diseased Men who have sex with mend Inmates of correctional facilitiesd Individuals with chronically elevated ALT or ASTd Individuals infected with hepatitis C virus (HCV) or HIVd Patients undergoing renal dialysisd All pregnant women
Persons needing immunosuppressive therapy a
b HBsAg prevalence 2%-7%. c
HBsAg prevalence 8%. d Those who are seronegative should receive hepatitis B vaccine.
If HBsAg-positive persons are found in the first generation, subsequent generations should be tested.
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