Screening for Hepatitis B

Patients with chronic hepatitis B virus (HBV) infection are often asymptomatic, but they are at risk for serious health consequences, including cirrhosis, liver failure, and hepatocellular carcinoma if they have active disease, and may need antiviral therapy. As primary care providers, nurse practitioners (NPs) may be the first and sometimes the only health care provider an HBV-infected individual may encounter. This article describes a new algorithm that can aid NPs in knowing whom to screen for HBV infection and how to follow up based on screening results, including what additional tests to order, necessary monitoring, and when to refer.