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Appendix C

Postexposure Prophylaxis of Persons with Discrete Identifiable Exposures to Hepatitis B Virus (HBV)

This appendix provides recommendations for management of persons who are exposed to HBV through a discrete, identifiable exposure to blood or body fluids that contain blood. Recommendations for management of infants born to mothers who test positive for hepatitis B surface antigen (HBsAg) are provided in this report (see Prevention of Perinatal HBV Transmission and Management of Pregnant Women).

HBsAg-Positive Source

  • Unvaccinated persons (Table C-1) or persons known not to have responded to a complete hepatitis B vaccine series should receive both hepatitis B immune globulin (HBIG) and hepatitis B vaccine as soon as possible after exposure (preferably <24 hours). For sexual exposures, HBIG should not be administered more than 14 days after exposure. Hepatitis B vaccine may be administered simultaneously with HBIG in a separate injection site. The hepatitis B vaccine series should be completed using the age-appropriate vaccine dose and schedule (see Tables 2 and 3).
  • Persons who are in the process of being vaccinated but who have not completed the vaccine series should receive the appropriate dose of HBIG and should complete the vaccine series.
  • Children and adolescents who have written documentation of a complete hepatitis B vaccine series and who did not receive postvaccination testing should receive a single vaccine booster dose.

Source with Unknown HBsAg Status

  • Unvaccinated persons (Table C-1) should receive the hepatitis B vaccine series with the first dose initiated as soon as possible after exposure, preferably <24 hours. The vaccine series should be completed using the age-appropriate dose and schedule (see Tables 2, 3, and 5).
  • Persons who are not fully vaccinated should complete the vaccine series.
  • Children and adolescents with written documentation of a complete hepatitis B vaccine series require no further treatment.

Table C-1

Table C-1
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A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: Immunization of Infants, Children, and Adolescents



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