A sexually active 22-year-old man seeks hepatitis B vaccination following exposure; lab results show anti-HBV negative, HBsAg positive, HBeAg negative. Which vaccines are recommended?

A sexually active 22-year-old man seeks hepatitis B vaccination following exposure; lab results show anti-HBV negative, HBsAg positive, HBeAg negative. Which vaccines are recommended?

• A. The patient needs hep B vaccine and hep B immunoglobulin.
• B. The patient needs no vaccine or immunoglobulin.
• C. The patient should receive only the hep B vaccine.
• D. The patient should receive only hepatitis B immunoglobulin.

Answer: (A)

The situation calls for post-exposure prophylaxis for hepatitis B in someone who is not immune and has been exposed to an HBV-positive source. Since the patient’s anti-HBs is negative (not immune) and the source is HBsAg-positive (infectious), the best approach is to provide both immediate protection and long-term immunity. Hepatitis B immunoglobulin offers rapid passive antibodies to help neutralize the virus right away, while starting the hepatitis B vaccine series builds active immunity that will protect long-term. AdministerHBIG as soon as possible after exposure (ideally within days) and begin the vaccine series now (with subsequent doses to complete the series). The combination is used because it gives immediate protection and establishes lasting immunity, even if the source’s HBeAg status suggests varying levels of infectiousness.

The situation calls for post-exposure prophylaxis for hepatitis B in someone who is not immune and has been exposed to an HBV-positive source. Since the patient’s anti-HBs is negative (not immune) and the source is HBsAg-positive (infectious), the best approach is to provide both immediate protection and long-term immunity. Hepatitis B immunoglobulin offers rapid passive antibodies to help neutralize the virus right away, while starting the hepatitis B vaccine series builds active immunity that will protect long-term. AdministerHBIG as soon as possible after exposure (ideally within days) and begin the vaccine series now (with subsequent doses to complete the series). The combination is used because it gives immediate protection and establishes lasting immunity, even if the source’s HBeAg status suggests varying levels of infectiousness.