Studies have shown that many primary care providers cannot differentiate between adult populations that should be screened for chronic hepatitis B because of their high prevalence of chronic infection (for example, people born in geographic regions with high HBV endemicity; see Box 3-1) and populations that should be vaccinated against HBV because of their high risk of becoming newly infected (for example, health-care workers, men who have sex with men, prison inmates, and household and sexual contacts of chronically infected individuals) (Euler et al., 2003b; Ferrante et al., 2008; Lai et al., 2007).
In a survey of primary care providers in San Francisco, all 91 respondents correctly answered that Chinese immigrants have a higher prevalence of chronic hepatitis B than non-Hispanic white or US-born Chinese people. However, a portion of the same group incorrectly identified HIV-infected
Geographic Regions That Have Intermediate and High Hepatitis B Virus Endemicity
Africa: all countries
Asia and Middle East: all countries
South and Western Pacific: all countries and territories but only indigenous persons in Australia and New Zealand
Eastern Europe: all countries except Hungary
Western Europe: Greece, Malta, Portugal, and Spain and indigenous populations of Greenland
North America: Alaska natives and indigenous populations of northern Canada
Central America: all countries
South America: Argentina, Bolivia, Brazil, Ecuador, Guyana, Suriname, Venezuela, and Amazonian areas of Colombia and Peru
Caribbean: Antigua and Barbuda, Dominica, Dominican Republic, Grenada, Haiti, Jamaica, Puerto Rico, St. Kitts and Nevis, St. Lucia, St. Vincent and Grenadines, Trinidad and Tobago, and Turks and Caicos
SOURCE: Modified from Mast et al., 2006.