Recently, while having coffee with a friend, we talked about this topic. "Have you ever been tested for Hepatitis B?" I thought for sure I had, but I realized I couldn't remember seeing the results.

When I was in school in Korea, I think I received some kind of vaccination, but I was confused about whether it was a vaccine or a test. So, I decided to look into it properly this time.

To get straight to the point, the CDC in the U.S. changed its recommendation in 2023, advising that all adults aged 18 and older should be tested for Hepatitis B at least once in their lifetime. Previously, the focus was mainly on high-risk groups.

This information was published in the CDC's Morbidity and Mortality Weekly Report (MMWR) in March 2023, and in an official letter sent to healthcare providers, it was described as a "significant update." This indicates a major change.

I was curious why it specifically applies to all adults, but the numbers helped me understand. According to the CDC report, the estimated number of people living with the Hepatitis B virus in the U.S. ranges from 580,000 to 2.4 million.

Even more surprising is that two-thirds of them may not even be aware of their infection. They go on without symptoms.

The scary part about Hepatitis B is that it progresses silently. If there is a chronic infection, the risk of cirrhosis and liver cancer increases, and the CDC states that the likelihood of early death is 70-85% higher than in the general population.

There's a number that resonates more with our Korean community. While 14% of the total U.S. population is foreign-born, 69% of chronic Hepatitis B patients are foreign-born.

The mortality rate for Hepatitis B is also reported to be highest among Asian and Pacific Islander groups. Honestly, this part hit home for me.

I also looked into the situation in Korea. Since 1983, Korea has recommended Hepatitis B vaccinations for newborns, and prior to that, a review paper indicated that 8% of the general population tested positive for the surface antigen.

Analysis of the Korean National Health and Nutrition Examination Survey shows that the positivity rate dropped from 4.61% in 1998 to 2.98% in 2010. Among teenagers, it decreased significantly from 2.2% to 0.12%.

The problem is that the positivity rate for those over 50 has hardly decreased. This indicates a generation that did not receive the benefits of vaccination as children. This includes first-generation immigrant parents and my generation.

So how do you get tested? The CDC recommends a combination of three blood tests known as the "triple panel."

The first is HBsAg, which tests for the surface antigen. It checks if you are currently infected.

The second is anti-HBs, which tests for surface antibodies. It determines whether immunity has developed from vaccination or past infection.

The third is total anti-HBc, which tests for core antibodies. It indicates whether you have been infected in the past and recovered.

When you look at these three tests together, the results are clearly categorized. There are people who need treatment due to current infection, those who had past infections and need to be cautious about reactivation, and those who need to get vaccinated due to lack of immunity.

I found the reactivation part particularly new. If you later need chemotherapy or immunosuppressants, having a record of past infections becomes important.

Let's also touch on vaccinations. According to CDC guidelines, people who have not been vaccinated can receive their first dose immediately after having their blood drawn, without waiting for the results.

And the memory of "I might have been vaccinated as a child" is often not reliable. A study conducted on Asian adults in the Bay Area found that self-reported vaccination history did not align well with actual immunity status.

Pregnant individuals have separate guidelines. Regardless of vaccination status, they are advised to be tested during each pregnancy, preferably within the first three months.

What about insurance? The U.S. Preventive Services Task Force (USPSTF) recommends testing for adolescents and adults at high risk for infection as a grade B recommendation, so it is often covered as a preventive service.

However, since the application varies by plan, it's a good idea to check with your insurance company beforehand to see if "hepatitis B screening is covered as preventive."

From my experience, it wasn't difficult. I requested the triple panel during my annual check-up, and it was just one blood draw.

Of course, interpreting the results, vaccination schedules, and treatment options vary for each person, so you should definitely consult with a doctor or pharmacist. You shouldn't make judgments based solely on internet articles.

When discussing climate or environmental issues, I often say, "Not knowing is the biggest cost," and I think health is the same. The more quietly problems accumulate, the earlier we need to address them.

If it were me, I would request this test during my check-up at the end of the year. I also plan to bring this up when I accompany my parents to their medical appointments.

It's a simple test that only requires one blood draw once in a lifetime. If you can't remember seeing your results, take this opportunity to check it out.