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

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

• Occupational exposure
• Sexual assault
• HIV post-exposure prophylaxis
• Hepatitis B
• Post exposure prophylaxis antibiotics

References

Authors

Daniel Ostermayer, Ross Donaldson