Hep C and B exposure prophalaxis

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Author:
thanuka
ID:
59138
Filename:
Hep C and B exposure prophalaxis
Updated:
2011-01-11 11:59:44
Tags:
Prevention
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Description:
Management of healthcare workers exposed to hepatitis B virus or hepatitis C virus
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  1. Definition of exposure ?
    A percutaneous injury (eg, a needlestick or cut with a sharp object)

    Contact of mucous membrane or nonintact skin (eg, exposed skin that is chapped, abraded, or afflicted with dermatitis)
  2. OSHA requirements post exposure
    Documentation of the route(s) of exposure and the circumstances

    Source exposure documentation: Not leagally required to test

    Results of the source individual's testing shall be made available to the exposed employee.

    • The exposed employee's blood shall be collected as soon as feasible and tested after consent is obtained. If the employee consents to baseline blood collection, but does not give consent at the time for HIV serologic testing, the sample shall be preserved for at least 90 days.
    • Postexposure prophylaxis should be administered when medically indicated, as recommended by the United States Public Health Service.

    The employer shall obtain and provide the employee with a copy of the evaluating healthcare professional's written opinion within 15 days of the completion of the evaluation.
  3. HBV infection — Postexposure prophylaxis
    If the source patient is HBsAg positive and the exposed person is unvaccinated, HBIG also should be administered as soon as possible after exposure (preferably within 24 hours) and the vaccine series started.

    If the exposed person had an adequate antibody response (>10 mIU/mL) documented after completion of an HBV vaccination series, no testing or treatment is needed, although some experts would consider administration of a booster dose of vaccine

    If the exposed is known non responder to the vaccine and the source is HBsAg positive then HBIG x2 or HBIG x 1 and vaccinate. if source HbsAg neg then no treatment. in unkown treat

    If antibody response is not known then test exposed and source positive then check for anti HbS if inadequate HBIG x 1 vaccine booster, if adequate no tx. if source HesAg - then no Tx. if unkown treat.
  4. Hep C exposure
    HCV-positive source have the following baseline and follow-up testing

    * Baseline testing for anti-HCV, HCV RNA, and alanine aminotransferase (ALT)

    * Follow-up testing for HCV RNA between four and six weeks after exposure

    * Follow-up testing for anti-HCV, HCV RNA, and ALT between four and six months after exposure

    persons exposed to an HCV-positive source should have a baseline immunoblot or HCV RNA assay

    Vaccinate for hep B

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