Screening for Hepatitis B Virus Infection in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force; Krist, Alex H.; Davidson, Karina W.; Mangione, Carol M.; Barry, Michael J.; Cabana, Michael; Caughey, Aaron B.; Donahue, Katrina; Doubeni, Chyke A.; Epling, John W.; Kubik, Martha; Ogedegbe, Gbenga; Owens, Douglas K.; Pbert, Lori; Silverstein, Michael; Simon, Melissa A.; Tseng, Chien-Wen; Wong, John B.

doi:10.1001/jama.2020.22980

Cited by 212Hepatitis B Virus StudiesHepatitis C virus researchHealth Promotion and Cardiovascular Prevention

Screening for Hepatitis B Virus Infection in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement

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US Preventive Services Task Force, Krist, Alex H., Davidson, Karina W., Mangione, Carol M., Barry, Michael J., Cabana, Michael, Caughey, Aaron B., Donahue, Katrina +10 more·2020·JAMA

DOI 10.1001/jama.2020.22980

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Abstract

Importance: An estimated 862 000 persons in the US are living with chronic infection with hepatitis B virus (HBV). Persons born in regions with a prevalence of HBV infection of 2% or greater, such as countries in Africa and Asia, the Pacific Islands, and parts of South America, often become infected at birth and account for up to 95% of newly reported chronic infections in the US. Other high-prevalence populations include persons who inject drugs; men who have sex with men; persons with HIV infection; and sex partners, needle-sharing contacts, and household contacts of persons with chronic HBV infection. Up to 60% of HBV-infected persons are unaware of their infection, and many remain asymptomatic until onset of cirrhosis or end-stage liver disease. Objective: To update its 2014 recommendation, the USPSTF commissioned a review of new randomized clinical trials and cohort studies published from 2014 to August 2019 that evaluated the benefits and harms of screening and antiviral therapy for preventing intermediate outcomes or health outcomes and the association between improvements in intermediate outcomes and health outcomes. New key questions focused on the yield of alternative HBV screening strategies and the accuracy of tools to identify persons at increased risk. Population: This recommendation statement applies to asymptomatic, nonpregnant adolescents and adults at increased risk for HBV infection, including those who were vaccinated before being screened for HBV infection. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for HBV infection in adolescents and adults at increased risk for infection has moderate net benefit. Recommendation: The USPSTF recommends screening for HBV infection in adolescents and adults at increased risk for infection. (B recommendation).

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The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, having multiple partners, men having sex with men, having history of other STIs, and injecting drug use.
“The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, having multiple partners, men having sex with men, having history of other STIs, and injecting drug use (233).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [233]
The Assessment of Risk section lists sexual partners of people with HBV, men who have sex with men, and people who inject drugs as risk groups. It does not identify multiple partners or a history of other STIs as risk factors, and it emphasizes birth in a high-prevalence region as accounting for most new chronic HBV infections in the US. Page numbers are unavailable in our copy. (LLM, conf=0.88)
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Authors: US Preventive Services Task Force, Krist, A. H., Davidson, K. W., Mangione, C. M., Barry, M. J., Cabana, M., Caughey, A. B., Donahue, K., Doubeni, C. A., Epling, J. W., Kubik, M., Ogedegbe, G., Owens, D. K., Pbert, L., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B.
Affiliations: Virginia Commonwealth University (US)
Northwell Health (US)
Harvard University (US)
Oregon Health & Science University (US)
University of North Carolina at Chapel Hill (US)
Mayo Clinic (US)
George Mason University (US)
New York University (US)
University of Massachusetts Chan Medical School (US)
Boston University (US)
Northwestern University (US)
University of Hawaiʻi at Mānoa (US)
Tufts University (US)
Corresponding author: Krist, Alex H.
ORCID: Krist, Alex H.
Davidson, Karina W.
Mangione, Carol M.
Barry, Michael J.
Cabana, Michael
Caughey, Aaron B.
Donahue, Katrina
Doubeni, Chyke A.
Epling, John W.
Kubik, Martha
Ogedegbe, Gbenga
Pbert, Lori
Silverstein, Michael
Simon, Melissa A.
Tseng, Chien-Wen
Wong, John B.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2020-12-15
Volume: 324
Issue: 23
Pages: 2415
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2020.22980
OpenAlex: W3010174353
Cited by: 212
References: 49
Citations by year: 2026: 13 · 2025: 11 · 2024: 23 · 2023: 35 · 2022: 38 · 2021: 55 · 2020: 37
FWCI: 29.57
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
eScholarship@UMassChan (submittedVersion)
eScholarship (California Digital Library) (submittedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
Health Sciences › Medicine › Hepatology › Hepatitis C virus research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords: hepatitis B virus, hepatitis B screening, chronic hepatitis B, adolescents, adults, vulnerable populations, asymptomatic infection, hepatitis B vaccination, antiviral therapy, screening accuracy, net benefit
MeSH terms: Adolescent, Adult, Hepatitis B Surface Antigens, Hepatitis B virus, Humans, Mass Screening, Risk Factors, United States, Hepatitis B Vaccines, Hepatitis B, Chronic, Emigrants and Immigrants

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Screening for Hepatitis B Virus Infection in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement

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