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Hepatitis B, acute
2024 Case Definition

Hepatitis B, acute
2024 Case Definition
NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

Subtype(s)

  • Hepatitis B, acute and chronic
  • Hepatitis B, chronic

Laboratory Criteria

Confirmatory Laboratory Evidence:

Tier 1

  • Detection of HBsAg† AND detection of IgM anti-HBc, OR
  • Detection of HBeAg AND detection of IgM anti-HBc, OR
  • Detection of HBV DNA†† AND detection of IgM anti-HBc, OR
  • Detection of HBsAg,† HBeAg, or HBV DNA within 12 months (365 days) of a negative HBsAg test result (i.e., HBsAg seroconversion).

Tier 2

  • Detection of HBV surface antigen (HBsAg)† AND IgM antibody to HBV core antigen (IgM anti-HBc) test not done or result not available, OR
  • Detection of HBV DNA†† AND IgM anti-HBc test not done or result not available.

Presumptive Laboratory Evidence:

  • Detection of IgM anti-HBc, AND
  • Negative or test not done for HBsAg, HBV DNA, or HBeAg.

Note: The categorical labels used here to stratify laboratory evidence are intended to support the standardization of case classifications for public health surveillance. The categorical labels should not be used to interpret the utility or validity of any laboratory test methodology.
† If information on HBsAg test method is available and HBsAg confirmatory neutralization was performed as recommended, HBsAg positive by confirmatory neutralization.
†† DNA detection by nucleic acid test, including qualitative, quantitative, or genotype testing.

Case Classification

Probable

  • Meets clinical criteria AND presumptive laboratory evidence of acute HBV infection.

Confirmed

  • Meets Tier 1 confirmatory laboratory evidence of acute HBV infection, OR
  • Meets clinical criteria AND Tier 2 confirmatory laboratory evidence of acute HBV infection.

Related Case Definition(s)

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National Notifiable Diseases Surveillance System (NNDSS)

NNDSS receives and shares case data from state, local, and territorial health departments to help public health monitor, control, and prevent serious diseases.

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