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Hepatitis B Postexposure Prophylaxis

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Hepatitis B Postexposure Prophylaxis, Postexposure Prophylaxis for Hepatitis B

  • See Also
  1. Hepatitis B
  2. Viral Hepatitis
  3. Sexually Transmitted Disease
  4. Bloodborne Pathogen Exposure
  5. Hepatitis B Prophylaxis in Newborns
  6. HIV Postexposure Prophylaxis
  • Indications
  1. Perinatal exposure
  2. Percutaneous or permucosal contact
  3. Sexual contact
  4. Household contact
  • Labs
  • Monitoring
  1. HBsAg at baseline, 6 weeks, 3 months, 6 months and 12 months
  2. HBsAb at 1-2 months after last dose of Vaccine
  1. Protocols below intended for healthcare worker exposure
  • Protocol
  • Known HBsAg Positive Source OR Unknown source status
  1. Unvaccinated exposed patient
    1. Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg within 24 hours of exposure and
    2. Hepatitis B Vaccine series
  2. Exposed patient with known response to Vaccine
    1. No treatment
  3. Exposed patient with known failed response to Vaccine (xHBsAg Antibody <10 mIU/ml)
    1. Patient has not yet completed a repeated, second 3-dose series
      1. Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg within 24 hours of exposure and
      2. Repeat Hepatitis B Vaccine (either one dose or a full 3-dose series)
      3. Recheck Immunity 1-2 months after last Hepatitis B dose
    2. Patient has completed a repeated second full 3-dose series (total of at least 6 Vaccine doses)
      1. Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg TWICE, one month apart
      2. No further Hepatitis BVaccination after 2 full Hepatitis B Series (>=6 doses)
  4. Exposed patient with unknown response to Vaccine
    1. Consider Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg within 24 hours of exposure
    2. Obtain xHBsAg Antibody levels
      1. Immunity if xHBsAg Antibody 10 mIU/ml or higher
    3. Inadequate xHBsAg Antibody levels (Hepatitis B Surface AntigenAntibody)
      1. Give Hepatitis B Vaccine booster dose OR second full three dose series AND
      2. Recheck HBsAb titers in 1-2 months after last Vaccine dose
  • Protocol
  • Known HBsAg Negative Source
  1. Administer Hepatitis B Vaccine Series if unvaccinated
  2. No treatment otherwise needed
  • Protocol
  • UnKnown HBsAg Source Status
  1. Treat most unknown exposures as Hepatitis B positive with protocol above
  • References
  1. Schillie (2013) MMWR Recomm Rep 62(RR-10):1-19 [PubMed]