The American College of Physicians ACP and the Centers for Disease Control and Prevention CDC have jointly issued new recommendations for care of patients with hepatitis B including screening and vaccination with an aim to reduce chronic hepatitis B infections by screening at risk adults increasing hepatitis B vaccination rates and linking infected persons to care. Published November 21 2017 in the Annals of Internal Medicine the best practice statements are as follows Hepatitis B vaccination is the most effective measure to prevent Hepatitis B infection and its complications. All unvaccinated adults including pregnant women at risk for infection due to sexual percutaneous or mucosal exposure should be vaccinated against HBV. Other high risk groups including health care and public safety workers at risk for blood exposure adults with chronic liver disease end stage renal disease including hemodialysis patients or HIV infection travelers to HBV endemic regions and adults seeking protection from HBV infection should also be advised vaccination. Clinicians should screen hepatitis B surface antigen antibody to hepatitis B core antigen and antibody to hepatitis B surface antigen for HBV in high risk persons including persons born in countries with 2 or higher HBV prevalence men who have sex with men persons who inject drugs HIV positive persons household and sexual contacts of HBV infected persons persons requiring immunosuppressive therapy persons with end stage renal disease including hemodialysis patients blood and tissue donors persons infected with hepatitis C virus persons with elevated alanine aminotransferase levels 8805 19 IU L for women and 8805 30 IU L for men incarcerated persons pregnant women and infants born to HBV infected mothers. All HBsAg positive patients should be referred for or provided posttest counseling and hepatitis B directed care Source Annals of Internal Medicine November 20 2017