Originally Published: 10 MAR 23 10:35 ET

By Jamie Gumbrecht, CNN

(CNN) -- A new recommendation from the US Centers for Disease Control and Prevention says all adults should be screened at least once in their lifetime for hepatitis B, an illness that's linked to liver disease and cancer.

The agency estimates 580,000 to 2.4 million people live with hepatitis B, known as HBV, and two-thirds might not know about their infection. Many people infected with hepatitis B clear the virus, but acute infection can lead to chronic hepatitis B, which is linked to increased risk of liver cancer and cirrhosis. People with chronic hepatitis B are 70 to 85% more likely to die early.

"Chronic HBV infection can lead to substantial morbidity and mortality but is detectable before the development of severe liver disease using reliable and inexpensive screening tests," the agency said in a report released Thursday.

Hepatitis B spreads through contact with infected blood or bodily fluids, which can occur through sex, injecting drugs, or during pregnancy or delivery.

The CDC's previous recommendation was made in 2008 and urged testing for people at high risk. Now, the agency recommends screening for everyone 18 and older at least once. The agency continues to recommend that pregnant people be screened during each pregnancy, regardless of whether they've been vaccinated or tested in the past. People at high risk -- including those who are incarcerated, have multiple sex partners or have a history of hepatitis C infection -- should be tested periodically.

The symptoms of acute hepatitis B infection can include fever, fatigue, abdominal pain, dark urine and jaundice, among others; these signs can take months to appear and can last for weeks or months, but most people clear the infection. People who progress to develop chronic hepatitis B often feel fine and don't have symptoms, sometimes for decades. But if symptoms do appear, they can look like the acute infection -- and may be a sign of advanced liver disease.

Several medications are available to treat people with chronic hepatitis B. There is also a highly effective vaccine against hepatitis B.

"Although a curative treatment is not yet available, early diagnosis and treatment of chronic HBV infections reduces the risk for cirrhosis, liver cancer, and death," the CDC said. "Along with vaccination strategies, universal screening of adults and appropriate testing of persons at increased risk for HBV infection will improve health outcomes, reduce the prevalence of HBV infection in the United States, and advance viral hepatitis elimination goals."