II. Indications
- Perinatal exposure
- Percutaneous or permucosal contact
- Sexual contact
- Household contact
III. Labs: Monitoring
IV. Protocol: General
- Protocols below intended for healthcare worker exposure
V. Protocol: Known HBsAg Positive Source OR Unknown source status
- Unvaccinated exposed patient
- Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg within 24 hours of exposure and
- Hepatitis B Vaccine series
- Exposed patient with known response to Vaccine
- No treatment
- Exposed patient with known failed response to Vaccine (xHBsAg Antibody <10 mIU/ml)
- Patient has not yet completed a repeated, second 3-dose series
- Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg within 24 hours of exposure and
- Repeat Hepatitis B Vaccine (either one dose or a full 3-dose series)
- Recheck Immunity 1-2 months after last Hepatitis B dose
- Patient has completed a repeated second full 3-dose series (total of at least 6 Vaccine doses)
- Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg TWICE, one month apart
- No further Hepatitis BVaccination after 2 full Hepatitis B Series (>=6 doses)
- Patient has not yet completed a repeated, second 3-dose series
- Exposed patient with unknown response to Vaccine
- Consider Hepatitis B Immunoglobulin (HBIG) 0.06 ml/kg within 24 hours of exposure
- Obtain xHBsAg Antibody levels
- Inadequate xHBsAg Antibody levels (Hepatitis B Surface AntigenAntibody)
- Give Hepatitis B Vaccine booster dose OR second full three dose series AND
- Recheck HBsAb titers in 1-2 months after last Vaccine dose
VI. Protocol: Known HBsAg Negative Source
- Administer Hepatitis B Vaccine Series if unvaccinated
- No treatment otherwise needed
VII. Protocol: UnKnown HBsAg Source Status
- Treat most unknown exposures as Hepatitis B positive with protocol above