Hepatitis B and C Reporting and Care - NYC Health

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By Disease or Condition

Immunizations

Alcohol and Drug Use

Smoking and Tobacco Use

Sexual and Reproductive Health

Infectious Diseases

Health Care-Associated Infections

Children and Adolescents

Immigrant Health


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

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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

Dear Colleague Letter: New Centers for Disease Control and Prevention Recommendations for Hepatitis C Testing Among Perinatally Exposed Infants and Children (PDF, June 14, 2024)

CDC Recommendations for Hepatitis C Testing Among Perinatally Exposed Infants and Children (PDF)

New York State Hepatitis C Clinical Guidelines

New York State Requirements for Universal Hepatitis C Testing: Health Care Provider Fact Sheet (PDF)

HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C

CDC recommendations for hepatitis C screening among adults (PDF)

A simplified algorithm for the management of hepatitis C infection. Gastroenterol Hepatol (PDF)

City Health Information: Diagnosing and Managing Hepatitis C (PDF)

American Association for the Study of Liver Diseases (AASLD) Practice Guidelines

CDC Hepatitis C Testing Algorithm: Recommended Testing Sequence for Identifying Current Hepatitis C Virus (HCV) Infection (PDF)

CDC Table: Interpretation of Results of Tests for Hepatitis C Virus (HCV) Infection and Further Actions (2013) (PDF)

Hepatitis C Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C (PDF)

Hepatitis C Hospital Dashboards

Bronx

BronxCare Health System (PDF)

Montefiore Medical Center (PDF)

NYC Health + Hospitals/Jacobi Medical (PDF)

NYC Health + Hospitals/Lincoln (PDF)

NYC Health + Hospitals/North Central Bronx (PDF)

St Barnabas Hospital (PDF)

Brooklyn

Brookdale University Hospital Medical Center (PDF)

Interfaith Medical Center (PDF)

Kingsbrook Jewish Medical Center (PDF)

Maimonides Medical Center (PDF)

Mount Sinai Brooklyn (PDF)

NewYork-Presbyterian Brooklyn Methodist Hospital (PDF)

NYC Health + Hospitals/Coney Island Hospital (PDF)

NYC Health + Hospitals/Kings County (PDF)

NYC Health + Hospitals/Woodhull (PDF)

NYU Langone Hospital-Brooklyn (PDF)

SUNY Downstate University Hospital of Brooklyn (PDF)

The Brooklyn Hospital Center (PDF)

Wyckoff Heights Medical Center (PDF)

Manhattan

Mount Sinai Beth Israel (PDF)

Mount Sinai Hospital (PDF)

Mount Sinai St. Luke’s (PDF)

Mount Sinai West (PDF)

NewYork Presbyterian/Columbia University Medical Center and Allen Hospital (PDF)

NewYork Presbyterian/Weill Cornell and Lower Manhattan Hospital (PDF)

Northwell Health — Lenox Hill Hospital (PDF)

NYC Health + Hospitals/Bellevue (PDF)

NYC Health + Hospitals/Harlem (PDF)

NYC Health + Hospitals/Metropolitan (PDF)

NYU Langone Tisch Hospital (PDF)

Queens

Flushing Hospital Medical Center (PDF)

Jamaica Hospital Medical Center (PDF)

Mount Sinai Queens (PDF)

NewYork Presbyterian Queens (PDF)

NYC Health + Hospitals/Elmhurst (PDF)

NYC Health + Hospitals/Queens Hospital Center (PDF)

St. John’s Episcopal Hospital (PDF)

Staten Island

Northwell Health — Staten Island University Hospital North (PDF)

Northwell Health — Staten Island University Hospital South (PDF)

Richmond University Medical Center (PDF)

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

CDC: Clinical Testing and Diagnosis for Hepatitis B

CDC Recommendations: Screening and Testing for Hepatitis B Virus Infection (PDF)

Universal hepatitis B vaccination in adults aged 19-59 years: Updated recommendations of the Advisory Committee on Immunization Practices (PDF, 2022)

City Health Information: Preventing, Identifying and Managing Hepatitis B Virus Infection (PDF)

American Association for the Study of Liver Diseases (AASLD) Practice Guidelines

Hepatitis B in Pregnancy — Provider Resources

CDC/ACIP: Prevention of Hepatitis B Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices

Additional Resources

Training and Support

Empire Liver Foundation Hepatitis Clinical Training Program: Offers Hepatitis B and C Grand Rounds, Clinical Management Training Series, and Preceptorship

Clinical Care Options — Hepatitis (CME): Video lectures and self-paced learning modules, including summaries from major hepatology conferences

LiverLearning®: American Association for the Study of Liver Diseases (AASLD)

Hepatitis A, B and C in New York City Annual Reports: An overview of the NYC Health Department’s surveillance and research data on hepatitis B and C in NYC, as well as programmatic activities to address these epidemics.

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

Hepatitis Patient Education Materials

Hepatitis Main Page