What are the ACIP recommendations for immunizing adults at risk for hepatitis B (HBV) (Hep B) infection?

Updated: Aug 01, 2018
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

The following are Advisory Committee on Immunization Practices (ACIP) recommendations for immunizing adults at risk for hepatitis B infection [100] :

  • History of current or recent injection drug use, international travelers to countries with high or intermediate levels of endemic HBV infection (HBsAg prevalence ≥2%)
  • Chronic liver disease (including, but not limited to, hepatitis C infection, cirrhosis, fatty liver disease, alcoholic liver disease, autoimmune hepatitis, and an alanine aminotransferase [ALT] or aspartate aminotransferase [AST] level greater than twice the upper limit of normal)
  • Human immunodeficiency virus infection
  • At risk for infection through sexual exposure (eg, sex partners of HBsAg-positive persons, sexually active persons not in a long-term mutually monogamous relationship, persons seeking evaluation or treatment for a sexually transmitted infection, men who have sex with men)
  • At risk for infection by percutaneous or mucosal exposure to blood (eg, household contacts of HBsAg-positive persons, residents and staff of facilities for developmentally disabled persons, healthcare and public safety personnel with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids, hemodialysis patients and predialysis, peritoneal dialysis, and home dialysis patients)
  • Persons with diabetes mellitus younger than 60 years and persons with diabetes mellitus aged at least 60 years at the discretion of the treating clinician [101]
  • Incarcerated persons
  • Other persons seeking protection from HBV infection (even without acknowledgment of a specific risk factor)

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