For individuals at high risk of HBVr, the AGA recommends antiviral prophylaxis over monitoring alone.
1. This recommendation assumes the use of antivirals with a high barrier to resistance.
2. Antiviral prophylaxis should be started before start of medications that impose risk of HBVr and should be continued for at least 6 months after discontinuation of risk-imposing therapy (at least 12 months for B cell–depleting agents).

For individuals at moderate risk of HBVr, the AGA suggests antiviral prophylaxis over monitoring alone.
1. This recommendation assumes the use of antivirals with a high barrier to resistance.
2. Patients who place a higher value on avoiding long-term use of antiviral therapy and the cost associated with its use, and a lower value on avoiding the small risk of reactivation (particularly in those who are HBsAg-negative) may reasonably select active monitoring over antiviral prophylaxis, with careful consideration of feasibility and likelihood of adherence to long-term monitoring. Monitoring should be performed at 1- to 3-month intervals, and must include assessment of hepatitis B viral load in addition to assessment of alanine aminotransferase.

For individual at low risk of HBVr, the AGA suggests monitoring alone over using antiviral prophylaxis.
1. This recommendation assumes regular and sufficient follow-up that ensures continued monitoring.
2. Patients who place a higher value on avoiding the small risk of reactivation (particularly those who may be on more than 1 low-risk immunosuppressive medication) and a lower value on the burden and cost of antiviral therapy may reasonably select antiviral therapy.

For individuals at risk of HBVr, the AGA recommends testing for hepatitis B.
1. Given universal Centers for Disease Control and Prevention (CDC) screening guidance for hepatitis B for all adults aged 18 years by testing for HBsAg, anti-HBs, and total anti-HBc, stratifying screening practices by magnitude of HBVr risk is no longer needed.
2. It is reasonable to test initially for serologic markers alone (at minimum for HBsAg, anti-HBc) followed by viral load testing (HBV-DNA) if HBsAg and/or anti-HBc is positive.