Hepatitis B Vaccination, Screening, and Linkage to Care

Publication Date: December 1, 2017
Last Updated: March 14, 2022

Best Practice Advice

Clinicians should vaccinate against hepatitis B virus (HBV) in all unvaccinated adults (including pregnant women) at risk for infection due to sexual, percutaneous, or mucosal exposure; health care and public safety workers at risk for blood exposure; adults with chronic liver disease, end-stage renal disease (including hemodialysis patients), or HIV infection; travelers to HBV-endemic regions; and adults seeking protection from HBV infection.

Clinicians should screen (hepatitis B surface antigen, antibody to hepatitis B core antigen, and antibody to hepatitis B surface antigen) for HBV in high-risk persons, including persons born in countries with 2% or higher HBV prevalence, men who have sex with men, persons who inject drugs, HIV-positive persons, household and sexual contacts of HBV-infected persons, persons requiring immunosuppressive therapy, persons with end-stage renal disease (including hemodialysis patients), blood and tissue donors, persons infected with hepatitis C virus, persons with elevated alanine aminotransferase levels (≥19 IU/L for women and ≥30 IU/L for men), incarcerated persons, pregnant women, and infants born to HBV-infected mothers.

Clinicians should provide or refer all patients identified with HBV (HBsAg-positive) for posttest counseling and hepatitis B–directed care.

Recommendation Grading




Hepatitis B Vaccination, Screening, and Linkage to Care

Authoring Organization

Publication Month/Year

December 1, 2017

Last Updated Month/Year

August 7, 2023

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Document Objectives

Vaccination, screening, and linkage to care can reduce the burden of chronic hepatitis B virus (HBV) infection. However, recommendations vary among organizations, and their implementation has been suboptimal. The American College of Physicians' High Value Care Task Force and the Centers for Disease Control and Prevention developed this article to present best practice statements for hepatitis B vaccination, screening, and linkage to care.

Target Patient Population

Patients high risk for Hepatitis B

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Long term care, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Assessment and screening, Prevention, Management

Diseases/Conditions (MeSH)

D006509 - Hepatitis B, D006505 - Hepatitis, D011315 - Preventive Medicine, D014611 - Vaccination, D017325 - Hepatitis B Vaccines


vaccination, screening, hepatitis B, preventive care


Number of Source Documents
Literature Search Start Date
January 1, 2005
Literature Search End Date
June 1, 2017