Recommended HBV PEP
Treatment when source is found to be:
Vaccination and antibody response
status of exposed worker*
Source Unknown or not available for
†
HB
positive
HBsAg negative
testing.
§
Initiate hepatitis B vaccine series
Initiate hepatitis B vaccine series.
Unvaccinated
HBIG
x 1 and initiate hepatitis B
vaccine series.
Previously vaccinated
No treatment
No treatment
No treatment
Known responder
HBIG x 1 and initiate
No treatment
If known high risk source, treat as if
Known non-responder
Re-vaccination or HBIG x 2**
source were HBsAg positive.
Test exposed person for anti-
No treatment
Test exposed for anti-HBs:
Antibody response unknown
††
HBs
1. If adequate, no treatment
1. If adequate, no treatment
2. If inadequate, vaccine booster
2. If inadequate, HBIG x 1
and recheck titer in 1-2 months
and vaccine booster
*
Persons who have previously been infected with HBV are immune to reinfection and do not require post-exposure prophylaxis.
†
Hepatitis B surface antigen.
§
Hepatitis B immune globulin; dose 0.06 ml/kg intramuscularly.
¶
A responder is a person with adequate levels of serum antibody to ABsAg (i.e., anti-HBs ≥ 10 mlU/ml); a non-responder is a person with inadequate
response to vaccination (i.e., serum anti-HBS < 10 mlU/ml).
** The option of giving one dose of HBIG and reinitiating the vaccine series is preferred for non-responders who have not completed a second 3-dose vaccine
series but failed to respond, 2 doses of HBIG are preferred. Give one dose at time of exposure, and the second dose one month later.
††
Antibody to HBsAg.