Practice Guidelines

Hepatitis B Virus Vaccination and Screening: Best Practices from the ACP and CDC


Am Fam Physician. 2018 Jul 15;98(2):121-122.

Author disclosure: No relevant financial affiliations.

Key Points for Practice

• Hepatitis B vaccine should be given to persons at risk of HBV infection because of sexual or blood exposure or international travel; persons with chronic liver disease, end-stage renal disease, or human immunodeficiency virus infection; at-risk pregnant women; and persons who request HBV protection.

• Persons at risk of HBV infection should be screened with hepatitis B surface antigen or hepatitis B core antibody or surface antigen antibody testing.

• Persons diagnosed with HBV infection should be evaluated for therapy if needed and offered hepatocellular carcinoma surveillance, behavioral risk reduction counseling, and vaccination of appropriate contacts.

From the AFP Editors

Approximately 847,000 persons in the United States have chronic hepatitis B virus (HBV) infection; 67% are unaware of their status, and 14,000 die annually. Screening and vaccination are beneficial in identifying and preventing HBV; however, these interventions are often not used, with only about one-fourth of adults receiving a full HBV vaccination series. For these reasons, increasing the use of screening and vaccination is a public health priority.

Because guidance from health care organizations varies, the American College of Physicians (ACP) and Centers for Disease Control and Prevention (CDC) chose to highlight the consensus among these recommendations, with recent evidence, to develop a best practice advice statement for vaccination, screening, care, and treatment of patients at risk of or who currently have HBV infection. Barriers to appropriate vaccination, screening, and care may include patient lack of knowledge about HBV or the vaccine, misinformation, difficulties with language, lack of health insurance, and trouble navigating the health care system. Physician barriers include lack of familiarity with HBV guidelines and risk of infection in certain patient populations.


The HBV vaccination series, which is typically given as three or four doses,

Author disclosure: No relevant financial affiliations.

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.

A collection of Practice Guidelines published in AFP is available at



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