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)