Management of suspected or confirmed exposure to hepatitis B virus
National HBV Testing Policy Expert Reference Committee 2020
The general principles of postexposure prophylaxis (PEP) against hepatitis B virus are summarised in Management of adults with suspected or confirmed exposure to hepatitis B virus.
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Exposed person is immune [NB1] |
Exposed person is not immune [NB1] | |
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Source is HBsAg negative and unlikely to be in window period [NB2] |
No further follow-up testing required. No preventive measures required. |
No further follow-up testing required. Start a course of hepatitis B vaccination as soon as possible, preferably within 24 hours of exposure [NB3]. |
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Source is HBsAg positive |
No further follow-up testing required. No preventive measures required. |
Test the exposed person for HBsAg at baseline, 3 months and 6 months after the exposure. Start a course of hepatitis B vaccination as soon as possible, preferably within 24 hours of exposure [NB3]. Administer hepatitis B immunoglobulin within 72 hours of exposure [NB3] [NB4]. |
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Source HBsAg status is unknown and cannot be urgently determined |
No further follow-up testing required. No preventive measures required. |
Test the exposed person for HBsAg at baseline, 3 months and 6 months after the exposure. Start a course of hepatitis B vaccination as soon as possible, preferably within 24 hours of exposure [NB3]. If occupationally exposed to the blood of unidentified people, administer hepatitis B immunoglobulin within 72 hours of exposure [NB3]. |
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Note:
HBsAg = hepatitis B surface antigen NB1: A person is immune if they have evidence of seroconversion after hepatitis B vaccination, or natural immunity from past infection. NB2: The window period refers to the time between infection and when hepatitis B virus is detectable. NB3: For immunisation and immunoglobulin dosing and schedule recommendations, see the Australian Immunisation Handbook. NB4: In the case of sexual exposure, hepatitis B immunoglobulin may be given up to 14 days after the last exposure. | ||