Hepatitis B
Revision as of 10:34, 23 July 2016 by Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==")
Background
Clinical Features
Differential Diagnosis
Evaluation
Management
Post Exposure Prophylaxis
Hepatitis B Post-Exposure Prophylaxis
Treatment is generally initiated after coordination with occupational health and infectious disease service and based the the exposed patient's vaccination history[1]
Unvaccinated
- If the source is HBsAg(+) then give HBIG x1 and initiate HBV vaccine in two separate sites
- If source is HGsAG(-) then start the HBV vaccine series
- If source blood is unavailable and high risk then give HBIG x1 initiate the HBV series
- If source blood is low risk and unavailable then begin HBV series
Previously vaccinated non responder (one series)
Non responder status is defined as anti-has <10mIU/mL
- If the source is HBsAg(+) then give HBIG x 1 and begin revaccination series
- Can also opt to perform second HBIG administration in one month
- If source is HBsAg(-) then no treatment is needed
- If source blood is unavailable and high risk then treat as if HBsAg(+)
Previously vaccinated non responder (two series)
Non responder status is defined as anti-has <10mIU/mL
- If the source is HBsAg(+) then give HBIG x2 and no HBV series
- If source is HGsAG(-) then no treatment is needed
- If source blood is unavailable then initiate the HBV series
Treatment Dosing
No contraindications for pregnancy or breast feeding
- HBIG 0.06 mL/kg IM
- Give in opposite arm from hepatitis B vaccine if patient also receiving vaccine
- Vaccination series: HBV vaccine options:
- Engerix-B 20mcg IM
- Recombivax HB 10mcg IM
Disposition
See Also
External Links
References
- ↑ Postexposure prophylaxis to prevent hepatitis b virus infection. CDC MMWR http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a3.htm?s_cid=rr5516a3_e