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A giant leap forward for Hepatitis B Care in California

A New Hep B Trifecta in California

In March of 2023, the CDC issued new recommendations for universal adult screening for Hepatitis B. The recommendation completed a trifecta of recent Hepatitis B developments that could significantly improve Hepatitis B screening, vaccination and treatment while saving lives and money.

  • October 2021: California law AB789 passed, requiring Hep B and Hep C tests to be offered in primary care settings.
  • February 2022: CDC recommends Hep B vaccination for those 19-59, infants, adolescents, and those 60+ at risk or desire vaccine.
  • March 2023: CDC recommends universal adult Hep B screening.

In October of 2021, California passed AB 789 into law, requiring all primary health care providers to offer a screening test for Hep B and C to the extent these services are covered under a patient's health insurance, based on the latest screening indications recommended by the United States Preventive Services Task Force. This made California the first state in the nation to take a major legislative step towards ending the Hep B and C epidemic in the State and the nation.

Numbers and Cost

In the United States, an estimated 1.9 million people are infected with chronic Hepatitis B1 with two thirds of those infected unaware of their infection. Additionally an estimated 2.4 -4.7 million are infected with hepatitis C2 and about 51% are unaware of their infection. In California, these numbers are 305,000 and 318,900 respectively.3,4 Despite the existence of affordable and effective screening for both diseases and an affordable vaccine for Hep B (HBV) and Hep C (HCV), the infection accounts for over a third of the liver transplant costs in California each year. Hepatitis-related liver transplants costs in California are roughly $50-70 million annually and over half a billion dollars in the past decade.5

A Unique Opportunity to Beat Hepatitis B

These three components pave the way for simple, easy, and affordable preventative care that stands to save countless lives and millions of dollars. Some major healthcare institutions have standardized Hep C screening and others have begun to pilot standardized Hep B screening and vaccination into their EMR and standards of care with promising results. It is now up to health systems, physician groups and advocates to make these new standards of care the norm. The combination of consistent, improved screening and universal vaccination (for Hep B) would significantly decrease the harm Hep B and C cause in California and the nation as well as help the country reach its own Hepatitis elimination goals.

It is easy, simple and cost saving. We have all the tools we need and it is time to end these epidemics once and for all. Integrate Hepatitis B and C testing and treatment today.


[1] Wong, Robert J et al. “An Updated Assessment of Chronic Hepatitis B Prevalence Among Foreign-Born Persons Living in the United States.” Hepatology (Baltimore, Md.) vol. 74,2 (2021): 607-626. doi:10.1002/hep.31782

[2]Edlin, Brian R et al. “Toward a more accurate estimate of the prevalence of hepatitis C in the United States.” Hepatology (Baltimore, Md.) vol. 62,5 (2015): 1353-63. doi:10.1002/hep.27978

[3] Toy, M., Wei, B., Virdi, T.S. et al. Racial/ethnic- and county-specific prevalence of chronic hepatitis B and its burden in California. Hepatology Medicine Policy 3, 6 (2018).

[4] Rosenberg ES, Rosenthal EM, Hall EW, et al. Prevalence of Hepatitis C Virus Infection in US States and the District of Columbia, 2013 to 2016. JAMA Netw Open. 2018;1(8):e186371. doi:10.1001/jamanetworkopen.2018.6371

[5] Schnitzler, M A et al. “OPTN/SRTR 2016 Annual Data Report: Economics.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons vol. 18 Suppl 1 (2018): 464-503. doi:10.1111/ajt.14564