Hepatitis B Follow-up Protocol
In all cases of exposure:
- source should have Hepatitis B surface antigen (HBsAg) done
- recipient should have baseline testing done
SOURCE: HBsAg positive
RECIPIENT
| Anti-HBs positive | Anti-HBs negative (not immunized) | Anti-HBs negative, immunized (non-responder) |
|---|---|---|
| No intervention |
- HBIG & Hepatitis B vaccination series - Anti-HBs titre 1 month after vaccination series (to allow waning of HBIG antibodies) - Follow-up HBsAg at 3 and 6 months |
- HBIG x 1 or 2 and vaccine booster - Anti-HBs titre at 6 months; if < 10 IU/L complete 2nd course of Hepatitis B vaccine - Follow-up HBsAg at 3 and 6 months (recent HBV vaccination can give false positive HBsAg test) |
SOURCE: HBsAg negative
RECIPIENT
| Anti-HBs positive | Anti-HBs negative (not immunized) | Anti-HBs negative, immunized (non-responder) |
|---|---|---|
| No intervention | - Hepatitis B vaccination series - Anti-HBs titre 1 month after vaccination series |
No intervention |
SOURCE: HBsAg status unknown/low risk
RECIPIENT
| Anti-HBs positive | Anti-HBs negative (not immunized) | Anti-HBs negative, immunized (non-responder) |
|---|---|---|
| No intervention | - Hepatitis B vaccination series - Anti-HBs titre 1 month after vaccination series - Follow-up HBsAg at 3 and 6 months |
- No intervention - Follow-up HBsAg at 3 and 6 months |
SOURCE: HBsAg status unknown/high risk
RECIPIENT
| Anti-HBs positive | Anti-HBs negative (not immunized) | Anti-HBs negative, immunized (non-responder) |
|---|---|---|
| No intervention |
- HBIG & Hepatitis B vaccination series - Anti-HBs titre 1 month after vaccination series (to allow waning of HBIG antibodies) - Follow-up HBsAg at 3 and 6 months |
If known high risk source: - HBIG x 1 or 2 and vaccine booster - Anti-HBs titre at 6 months; if < 10 IU/L complete 2nd course of Hepatitis B vaccine - Follow-up HBsAg at 3 and 6 months (recent HBV vaccination can give false positive HBsAg test) |