Template:Hepatitis B post exposure prophylaxis: Difference between revisions

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===[[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''<ref> Postexposure prophylaxis to prevent hepatitis b virus infection. CDC MMWR http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a3.htm?s_cid=rr5516a3_e</ref>
''Treatment is generally initiated after coordination with occupational health and infectious disease service and based the the exposed patient's vaccination history''<ref> Postexposure prophylaxis to prevent hepatitis b virus infection. CDC MMWR http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a3.htm?s_cid=rr5516a3_e</ref>
===Unvaccinated===
 
====Unvaccinated====
*If the source is HBsAg(+) then give HBIG x1 and initiate HBV vaccine in two separate sites
*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 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 unavailable and high risk then give HBIG x1 initiate the HBV series
**If source blood is low risk and unavailable then begin HBV series
**If source blood is low risk and unavailable then begin HBV series
===Previously vaccinated non responder (one series)===
 
====Previously vaccinated non responder (one series)====
''Non responder status is defined as anti-has <10mIU/mL''
''Non responder status is defined as anti-has <10mIU/mL''
*If the source is HBsAg(+) then give HBIG x 1 and begin revaccination series   
*If the source is HBsAg(+) then give HBIG x 1 and begin revaccination series   
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*If source is HBsAg(-) then no treatment is needed
*If source is HBsAg(-) then no treatment is needed
*If source blood is unavailable and high risk then treat as if HBsAg(+)
*If source blood is unavailable and high risk then treat as if HBsAg(+)
===Previously vaccinated non responder (two series)===
 
====Previously vaccinated non responder (two series)====
''Non responder status is defined as anti-has <10mIU/mL''
''Non responder status is defined as anti-has <10mIU/mL''
*If the source is HBsAg(+) then give HBIG x2 and no HBV series
*If the source is HBsAg(+) then give HBIG x2 and no HBV series
*If source is HGsAG(-) then no treatment is needed
*If source is HGsAG(-) then no treatment is needed
*If source blood is unavailable then initiate the HBV series
*If source blood is unavailable then initiate the HBV series
===Treatment Dosing===
 
''no contraindications for pregnancy or breast feeding''
====Treatment Dosing====
''No contraindications for pregnancy or breast feeding''
*HBIG 0.06 mL/kg IM
*HBIG 0.06 mL/kg IM
**Give in opposite arm from hepatitis B vaccine if patient also receiving vaccine
*Vaccination series: HBV vaccine options:
*Vaccination series: HBV vaccine options:
**Engerix-B 20mcg IM
**Engerix-B 20mcg IM
**Recombivax HB 10mcg IM
**Recombivax HB 10mcg IM

Latest revision as of 21:58, 24 January 2020

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