back to Canada directory
canada clinical guidance

Hepatitis B in primary care: who to test, how to interpret, when to refer

A Canadian clinical summary of hepatitis b in primary care: who to test, how to interpret, when to refer, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by The Management of Chronic Hepatitis B: 2025 Guidelines Update. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:CASL/AMMI HBV 2025

Source-attributed clinical priorities

  • Offer testing according to exposure, country of birth, pregnancy, household or sexual contact, immunosuppression and clinical liver disease risk.
  • Interpret surface antigen, surface antibody and core antibody together, adding viral markers when infection is identified.
  • Link active infection to staging and specialist care and notify public health according to the local requirement.
  • Interpret surface antigen, surface antibody and core antibody together rather than ordering or reading one marker in isolation.
sources for this section:CASL/AMMI HBV 2025

Practical assessment and management workflow

1
Identify birth country, household or sexual exposure, pregnancy, injection use, immunosuppression and liver disease risk.
2
Order the PHAC-recommended serologic panel and liver tests for the clinical question.
3
If infection is present, distinguish acute from chronic disease and assess viral activity and liver fibrosis.
4
Vaccinate susceptible contacts and arrange treatment or surveillance through the provincial hepatitis pathway.
sources for this section:CASL/AMMI HBV 2025

Safety, red flags and urgent escalation

  • Acute liver failure features require emergency hepatology assessment.
  • Screen before chemotherapy, biologic or potent immunosuppression because reactivation can be severe.
  • Pregnancy with positive surface antigen needs timely viral-load and perinatal-prevention coordination.
sources for this section:CASL/AMMI HBV 2025

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:CASL/AMMI HBV 2025

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:CASL/AMMI HBV 2025

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Canadian Association for the Study of the Liver and AMMI CanadaThe Management of Chronic Hepatitis B: 2025 Guidelines Updateaccessed 2026-08-20
    view source
continue the learning

From guidance to deliberate practice and evidence

Choose what happens next. iatroX can carry this page's jurisdiction, source-check date and released version into an editable learning record, support your reflection, or let you browse the regional question bank while keeping this topic visible. No action records completion, starts a session or awards CPD/CME credit automatically.

Add this guidance review to CPD/CMEOpen an editable learning-log record with this page鈥檚 provenance attached. You confirm the activity, time, reflection and mappings.Reflect on this with TutorUse optional prompts to consider what you learned and what鈥攊f anything鈥攜ou may change. Suggestions are never inserted automatically.Browse the Canada question bankKeep this guidance topic in view, then choose your exam and filters. No session starts automatically.
Found a source update or regional discrepancy? Tell the iatroX editorial team.