# Hepatitis B

Approximately 257 million people globally are positive for Hepatitis B.  Having Hepatitis B carries a risk of cirrhosis and liver cancer with chronic infection. Most transmission occurs at the time of childbirth from mother to child through there are a number of risk factors for transmission.  Hepatitis B vaccination provides effective protection against Hepatitis B infection.  

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<summary><strong>Is Hepatitis B routinely recommended for STI testing?</strong></summary>

We don’t routinely screen for hepatitis B as part of standard STI screening.  Current Canadian guidelines recommend screening if you have not been vaccinated for Hepatitis B and have one or more of the following risk factors:

* Exposure to someone with Hepatitis B through blood and/or bodily fluids
* Engage in high-risk sexual activities (unprotected sex with multiple sexual partners)
* Substance use with sharing of equipment
* Use of shared or contaminated materials or equipment (i.e instruments/tools used for personal services procedures that have the potential to break the skin)
* Use of shared or contaminated medical devices (i.e. glucometers)
* Occupational exposure to blood/body fluids
* Travel to/residence in endemic regions
* Transfusion recipient/medical procedure in Canada before 1970
* Incarceration&#x20;
* History of HIV or Hepatitis C
* Born in a country with a high risk of Hepatitis B infection

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<summary><strong>Who should not be screened for Hepatitis B?</strong></summary>

* You are vaccinated and do not carry special risk status (see below)
* You have a history of Hepatitis B infection<br>

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<summary><strong>When should I be checked?</strong></summary>

While there is no agreed-upon screening frequency, we recommend screening regularly in unvaccinated patients at least every 1-2 years with ongoing risk factor exposure.&#x20;

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<summary><strong>Should I be screened if I am vaccinated against Hepatitis B? (Special Risk Status)</strong></summary>

We recommend screening regardless of vaccination if you carry the following risk factors:&#x20;

* Are from areas where there is an intermediate (2%) > or higher risk of prevalence - see Referenced Map
* Are currently pregnant
* Require immunosuppressive therapy
* Are a donor or plasma, semen, organs or tissue
* Born to a mother with Hepatitis B

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<mark style="color:red;">**If you are concerned about a new Hepatitis B exposure and are seeking post-exposure prophylaxis, we recommend going to an emergency room and not using TeleTest.**</mark><br>

References

<https://www.cmaj.ca/content/192/43/E1299>

<https://www.canada.ca/en/public-health/services/reports-publications/primary-care-management-hepatitis-b-quick-reference.html#fn8>

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## General Questions

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<summary>Can I add Hepatitis B to my requisition?</summary>

These tests are only added in certain situations. Most patients don’t have these tests requested. See the link for more information: [https://docs.teletest.ca/hepatitis-b#is-hepatitis-b-routinely-recommended-for-sti-t](https://docs.teletest.ca/hepatitis-b#is-hepatitis-b-routinely-recommended-for-sti-testing)

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