PREVENTION AND CONTROL HEPATITIS B

PREVENTION AND CONTROL HEPATITIS B

Two available hepatitis B vaccines for immunization are Recombivax HB® and Engerix-B (SmithKline Beecham Biologicals).
• Pregnancy is not a contraindication to vaccination.

• For vaccination of adults 20 years of age and older:

• 1-mL dose by intramuscular injection into the deltoid muscle, at initial visit, then one month and six months after the first dose, for a total of three doses
• Consult package inserts for details.

Post exposure prophylaxis for susceptible pregnant women

After Exposure to Persons Who Have Acute Hepatitis B
When exposure has occurred as a result of sexual contact within 14 days after the most recent sexual contact administer

• A course of HBV vaccine into the deltoid as above
• A dose of Hepatitis B immune globulin (HBIG) 0.06 mL/kg IM
• Into the contralateral arm.
• For prophylaxis after percutaneous or mucous membrane injury, a second dose of HBIG should be given 1 month later.

Exposure to persons who have chronic HBV infection

Active post exposure prophylaxis with hepatitis B vaccine alone is recommended for sex or needle-sharing partners and non-sexual household contacts of persons with chronic HBV infection.

Viral vaccines and protective immune globulin preparations are available against HBV. Simple environmental procedures can limit the risk of infection to health care workers, laboratory personnel, and others. With this approach, all blood and fluids materials are considered infectious for HBV and other blood-borne pathogens. Exposure that might place workers at risk of infection include percutaneous injury (such as needle-stick injury) or contact of mucous membranes or non-intact skin (e.g. chapped, cuts, dermatitis) with blood tissue or other body fluids that are potentially infectious.

Methods are devised to prevent contact with such samples. Example of specific precautions include the following: gloves should be worn when handling all potentially infectious materials, protective garments should be worn and removed when leaving the work area; mask and eye protection should be worn whenever splashes or droplets from infectious material pose a risk; only disposable needles should be used; needles should be discarded directly into special containers without re-sheathing; work surfaces should be decontaminated using a bleach solution; and laboratory personnel should refrain from mouth-pipetting, eating, drinking and smoking in the work area (Brooks et al., 2004).

Metal objects and instruments can be disinfected by autoclaving or by exposure to ethylene oxide gas. It is important to use a condom for penetrative sex to prevent passing the virus. Sexual partners of the patient should be tested and immunized against HBV (if not already infected).

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