Building a Hepatitis B Continuum of Care Using Enhanced Public Health Surveillance Data

Monitoring engagement in hepatitis B (HBV) care is essential for identifying service gaps and guiding public health action. This work is especially timely following the FDA’s October 20, 2026, approval of bepirovirsen (Hibsago), which offers the possibility of functional cure for some eligible adults with chronic HBV. As the United States prepares to incorporate this treatment into care, health departments need stronger systems to identify people with diagnosed HBV, assess linkage and retention, and guide efforts to address inequities in access. This resource provides a practical foundation by showing how one jurisdiction combined routinely collected laboratory results with enhanced surveillance information to build an HBV continuum of care. hepb.org

The continuum includes five stages: ever screened positive, follow-up HBV testing, linked to care, ever retained in care, and currently retained in care. The example identifies individuals with a first positive HBV test between January 2013 and June 2020 and includes an additional 18 months of follow-up through December 2021. It combines an HBV surveillance registry, negative laboratory results, and death certificate data, using testing patterns and provider information as indicators of engagement in care.

For health departments adapting this approach, the resource emphasizes maintaining a person-based longitudinal laboratory registry that incorporates both positive and negative results. It acknowledges incomplete laboratory reporting, difficulty identifying individuals who have moved outside the jurisdiction, and limited treatment information. Although the continuum does not directly measure treatment eligibility or functional cure, it can help programs identify gaps in care and establish infrastructure for monitoring outcomes as treatment options expand. Programs can begin with a narrower population or fewer continuum stages and add measures as their data capacity grows.

For questions please contact Isabel Lechuga.