CDC Adopts Universal Adult HBV Screening and Testing Recommendations

On March 9, the Centers for Disease Control and Prevention (CDC) published a Morbidity and Mortality Weekly Report (MMWR), CDC Recommendations for Hepatitis B Screening and Testing-United States, 2022, that formally adopts updated screening and testing recommendations for hepatitis B virus (HBV). CDC now recommends universal HBV screening and testing for all adults in the United States at least once in their lifetime and expanded continual, periodic risk-based testing for populations that are at increased risk of HBV. The new screening and testing recommendations will support early diagnosis and linkage to care, facilitate greater detection of people living with chronic HBV, and serve as a key opportunity to inoculate unvaccinated adults. 

CDC adopted the universal screening guidelines to address the challenges identifying most people living with chronic HBV through risk-based testing alone. CDC estimates that more than half of people with HBV are undiagnosed. Additionally, CDC investigators identified universal screening as a cost-effective way to reduce HBV-related morbidity and mortality, reduce the prevalence of HBV in the U.S., and advance viral hepatitis elimination goals. The updated screening and testing recommendations expand 2008 guidelines to include HBV screening at least once in a lifetime for persons aged 18 years of age and older using a triple panel that includes tests for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), and total antibody to hepatitis B core antigen (total anti-HBc). CDC expanded continual, periodic risk-based testing recommendations to include people who are currently or formerly incarcerated or in other detention settings, people with a history of sexually transmitted infections or multiple sex partners, people with a history of hepatitis C, and anyone who requests HBV testing, regardless of disclosure of risk. The new HBV screening and testing recommendations complement CDC’s 2022 HBV vaccination recommendations that were updated to include universal preventive HBV vaccination for all adults aged 19-59. 

Broad patient and provider education will be required in order to effectively implement the recommendations. NASTAD members are strongly encouraged to notify critical stakeholders of the CDC’s updated adult HBV screening, testing, and vaccination recommendations and initiate planning for their immediate implementation. CDC will host a webinar on March 15, at 1 pm ET to discuss the updated recommendations. Additionally, click here to read a Dear Colleague Letter from Dr. Carolyn Wester, Director of the CDC Division of Viral Hepatitis on the significance of the universal HBV screening and testing recommendations.

Please contact Isabel Lechuga, Associate Director, Hepatitis with questions.