New guidance from U.S. public health experts broadens hepatitis B screening. The updated recommendations advise that all adults aged 18 and older should be tested for hepatitis B at least once in their lifetime. This shift aims to identify infections that might otherwise go unnoticed and to prompt timely care that can prevent serious complications. The emphasis is on a one-time test for most adults, recognizing that many people may carry the virus without obvious symptoms for years.
Chronic hepatitis B infection raises significant health risks, including liver scarring, liver cancer, and cirrhosis. People living with the virus have a notably higher risk of premature death compared with the general population. Transmission occurs through exposure to infected blood or bodily fluids, including through sexual contact, sharing needles, and during pregnancy and childbirth. Because the infection often presents without noticeable symptoms, screening plays a crucial role in early detection. Vaccination remains a highly effective defense, offering strong protection against infection when given according to recommended schedules.
The updated screening approach moves from a focus on only certain high-risk groups to a broader one-time testing strategy for adults 18 and older. Testing uses a panel of three laboratory markers to determine hepatitis B status: HBsAg, anti-HBs, and anti-HBc. In addition, individuals considered high risk are encouraged to have regular hepatitis B screening as part of ongoing health maintenance. This ensures that those most exposed to risk factors receive appropriate follow-up and monitoring over time, reducing chances of missed infections and helping guide vaccination and treatment decisions when needed.
By identifying infections earlier, health experts anticipate a decrease in the progression to cirrhosis, liver cancer, and the need for liver transplantation. The broader screening approach is intended to prevent severe outcomes and improve survival by enabling timely medical care and appropriate preventive measures. Overall, the goal is to reduce the burden of hepatitis B through routine screening, effective vaccination where applicable, and prompt linkage to care for those found to be infected.