Hepatitis B and C — Reporting and Care

Screening and management of hepatitis B and C is quickly evolving. Local providers should be familiar with hepatitis B and C screening recommendations and reporting requirements.

Reporting Requirements

Providers must report all suspected acute cases of hepatitis B and C.

There is no laboratory test that distinguishes acute from chronic hepatitis C. The NYC Department of Health relies on providers to report new cases of suspected acute hepatitis C. Providers do not need to report chronic hepatitis B and C.

You must report patients who:

  • Test positive for hepatitis B or C, with:
    • A discrete onset of signs and symptoms (e.g., dark urine, light stool, fatigue, fever, loss of appetite, diarrhea, nausea, vomiting, joint pain or abdominal pain) AND
    • Jaundice, or elevated liver enzymes that may indicate acute hepatitis infection.
  • Tested negative for hepatitis C in the past 12 months and now test positive.
  • Tested negative for hepatitis B surface antigen in the past six months and now test positive for hepatitis B (HBsAg, hepatitis B “e” antigen or hepatitis B virus nucleic acid testing).
  • Tested positive for hepatitis B surface antigen and are pregnant or recently gave birth.

Hepatitis C Testing and Care

Testing

Hepatitis C can be cured in almost all patients, including those who use drugs.

You should order a hepatitis C antibody test for any patient who is at risk of hepatitis C, including anyone who was born between 1945 and 1965. If a test is positive, you should also conduct a test for viral RNA to assess the patient’s infection status.

As of October 2017, laboratories performing hepatitis C testing for New York City residents are required to use an automatic confirmatory hepatitis C viral test for all positive hepatitis C antibody results (PDF).

Care

If your patient is infected with hepatitis C, you should provide treatment, as well as:

  • Educate and counsel about them liver health management and how to prevent hepatitis C transmission.
  • Offer appropriate vaccinations, including for hepatitis A and B.
  • Assess liver function and stage of liver disease.

If you cannot provide treatment to a patient with hepatitis C, you should refer them to a provider who manages hepatitis C.

Guidelines and Recommendations

Hepatitis B Testing and Care

Testing

You should screen any patient with risk factors for hepatitis B, as well as all anyone who was born in a country where hepatitis B prevalence is 2% or higher. You should also screen patients with hepatitis B surface antibody and surface antigen tests.

You should offer a hepatitis B vaccination to all at-risk adults who are not immune and any adult who would like to be vaccinated.

Care

If your patient is infected with hepatitis B, you should:

  • Complete a full medical evaluation, including an assessment of liver function, stage of disease and consideration for antiviral treatment.
  • Provide education on how to maintain liver health, recommended frequency of medical visits, and how to prevent transmission.
  • Screen and vaccinate other household and family members as well as sexual contacts.

If you cannot provide an assessment and treatment to a patient with hepatitis B, you should refer them to a provider who manages hepatitis B.

Guidelines and Recommendations

Additional Resources

Training and Support

Other Resources

  • Hep Free NYC: A coalition of providers, researchers, community-based organizations and advocates committed to addressing hepatitis-related issues in New York City.
  • For more resources or information, email hep@health.nyc.gov

More Information