Hepatitis B

Your commonly answered questions about 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.

Is Hepatitis B routinely recommended for STI testing?

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

• History of HIV or Hepatitis C

• Born in a country with a high risk of Hepatitis B infection

Who should not be screened for Hepatitis B?

• You are vaccinated and do not carry special risk status (see below)

• You have a history of Hepatitis B infection

When should I be checked?

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.

Should I be screened if I am vaccinated against Hepatitis B? (Special Risk Status)

We recommend screening regardless of vaccination if you carry the following risk factors:

• 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

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.

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

General Questions

Can I add Hepatitis B to my requisition?

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