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Postexposure Evaluation and Follow-up

Course Number: 472

Hepatitis B Virus (HBV)

Unvaccinated or incompletely vaccinated HCP exposed to a HBsAg-positive source person should receive HBV PEP as soon as possible (preferably within 24 hours) after exposure.4,5 HB immune globulin (HBIG) and the first dose of the HepB vaccine (if indicated) can be administered simultaneously at separate sites (HepB vaccine should always be administered in the deltoid muscle). Fully vaccinated HCP, defined as a person with anti-HBs ≥10 mIU/mL after ≥3 doses of HepB vaccine, require no HBV PEP.

Expert counseling is recommended for susceptible HCP exposed to the HBV, especially in cases of known or suspected pregnancy, breastfeeding, or serious medical illnesses. Additional information should be provided on any special precautions to prevent secondary transmission of the HBV during the follow-up period, current information on how to modify sexual practices and strategies to prevent pregnancy, and on donating blood, plasma, organs, tissue, or semen.4

No modifications of patient-care responsibilities are necessary based solely on an exposure to HBV-positive blood or OPIM.4 If an exposed person becomes acutely infected with the HBV, the person should be evaluated according to published recommendations for infected healthcare providers. Those who are chronically infected with the HBV should ensure adherence to the principles of Standard and Transmission-based Precautions and all other recommendations.6,7