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Hepatitis B Postexposure ProphylaxisAka: Postexposure Prophylaxis for Hepatitis B

See Also
Indications
1. Perinatal exposure
2. Percutaneous or permucosal contact
3. Sexual contact
4. Household contact
Protocol: General
1. Protocols below intended for healthcare worker exposure
Protocol: Known HBsAg Positive Source
1. Unvaccinated exposed patient
  1. Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg and
  2. Hepatitis B Vaccine
2. Exposed patient with known response to vaccine
  1. No treatment
3. Exposed patient with known failed response to vaccine
  1. Patient has not yet completed second 3-dose series
    1. Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg and
    2. Hepatitis B Vaccine (complete second 3-dose series)
  2. Patient has completed two prior 3-dose series
    1. Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg
    2. Second Hepatitis B Immunoglobulin dose
4. Exposed patient with unknown response to vaccine
  1. Test for Antibody to HBsAg
  2. Adequate Antibody (HBsAg Positive): No treatment
  3. Inadequate Antibody (HBsAg Negative)
    1. Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg and
    2. Hepatitis B Vaccine booster 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. Unvaccinated exposed patient
  1. Hepatitis B Vaccine Series
2. Exposed patient with known response to vaccine
  1. No treatment
3. Exposed patient with known failed response to vaccine
  1. Treat source as HBsAg positive if high risk
4. Exposed patient with unknown response to vaccine
  1. Test for Antibody to HBsAg
  2. Adequate Antibody (HBsAg Positive): No treatment
  3. Inadequate Antibody (HBsAg Negative)
    1. Hepatitis B Vaccine initial and booster dose
    2. Recheck titer in 1 to 2 months
Research
1. Lamivudine (3TC) effective for Hepatitis B prophylaxis

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.