Hepatitis B 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
  • Vaccination series: HBV vaccine options:
    • Engerix-B 20mcg IM
    • Recombivax HB 10mcg IM

See Also

References

  1. Postexposure prophylaxis to prevent hepatitis b virus infection. CDC MMWR http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a3.htm?s_cid=rr5516a3_e