abhi01
Forum Newbie
Topics: 6
Posts: 18
|
a previously vaccinated person was exposed to HBV infected blood. though this person was vaccinated earlier but there is no documentation of the response to HBV vaccine. anti-HBsAg level was done and it was not detected. what prophylaxis should he receive?
HBIG only
HBIG + HBV vaccination
|
| sachida
Forum Guru
Topics: 62
Posts: 663
|
HBIG+ HBV
Reference: the occupational setting, multiple doses of HBIG initiated within 1 week following percutaneous exposure to HBsAg-positive blood provides an estimated 75% protection from HBV infection (47--49). Although the postexposure efficacy of the combination of HBIG and the hepatitis B vaccine series has not been evaluated in the occupational setting, the increased efficacy of this regimen observed in the perinatal setting, compared with HBIG alone, is presumed to apply to the occupational setting as well. In addition, because persons requiring PEP in the occupational setting are generally at continued risk for HBV exposure, they should receive the hepatitis B vaccine series.
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm
___________________
Past is a history. Tomorrow is a mystery. What you have today is gift of God- that is why it is called present. Enjoy it...
|
| achilles
Forum Guru
Topics: 90
Posts: 1,228
|
immunoglobulin+vaccine.
thanks sachida for the info.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
|
| MAZI
Forum Elite
Topics: 8
Posts: 245
|
what,s your oponion about this?
at the first : give HBIG
then order HBS Ab, if positive no need for HBV vaccin
if negative then give booster
|
| achilles
Forum Guru
Topics: 90
Posts: 1,228
|
mazi, HBIG will only give you protection for a transient period(they are preformed antibodies) and it will not generate antibodies.
to generate antibodies HBV should be given which will generate both memory and antibodies and will give protection for almost a lifetime after the three doses are given.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
|
| achilles
Forum Guru
Topics: 90
Posts: 1,228
|
hope i gave the answer in the same context as your question
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
|
| MAZI
Forum Elite
Topics: 8
Posts: 245
|
achilles, u know that when the antibody against surface Ag of HBV is positive, it means lifelong immunity, don,t difference between immunity from disease or vaccination, the only difference is positive HBC Ab in disease. this person has a HX of vaccination , until confirmatin of immunity with lab, we can provide passive immunity with HBIG and after that ,we can select vaccination or not
HBS Ag= infection
HBS Ab= immunity
|
| sachida
Forum Guru
Topics: 62
Posts: 663
|
Guys, q stem already indicated that vaccination did not work since "anti-HBsAg level was done and it was not detected". By ANTI-hbsAg level it means HbSAb. Therefore, person needs another immunization.
___________________
Past is a history. Tomorrow is a mystery. What you have today is gift of God- that is why it is called present. Enjoy it...
|
| achilles
Forum Guru
Topics: 90
Posts: 1,228
|
thats right. the labs are already done in this pt and so both immunoglobulins and HBV are indicated in this pt as no immunity was demonstrated.
if after getting the labs, anti-HBsAG was detected then nothing is indicated.the pt would need only reassurance in such a case.
and if no anti-HBsAG is detected then we have to give both so no point in giving just immunoglobulins before the labs.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
|
|
| |
| | | | | | | | | |
Similar forum topics