Post-exposure management of hepatitis B

Occupational exposure is a problem that cannot be avoided in all hospitals. Occupational exposure refers to a type of occupational exposure in which medical personnel are exposed to toxic or harmful substances or infectious disease pathogens in the process of engaging in treatment and care activities, thereby damaging health or endangering life. According to statistics, occupational exposure occurs in China and its exposure source pathogens are mainly hepatitis B, hepatitis C, syphilis, AIDS and so on. The most common pathogen hepatitis B virus. What should be done after occupational exposure to hepatitis B? Occupationally exposed persons accidentally infected with hepatitis B virus are generally divided into the following cases: 1. HbsAb (-) HbsAg (-), have not received hepatitis B vaccine, intramuscular injection of hepatitis B immunoglobulin (HBIg) 200u within 24 hours, while completing the full course of hepatitis B vaccination, i.e., three injections of hepatitis B vaccine within 6 months (0, 1, 6 months); 2. Previously vaccinated with hepatitis B vaccine, no antibody production, in addition to intramuscular injection of hepatitis B immunoglobulin (HBIg) 200u within 24h, one booster injection of hepatitis B vaccine (20ug). 3.For hepatitis B occupationally exposed persons with HbsAb(+) and quantification <10 mIU/ml, in addition to intramuscular injection of hepatitis B immunoglobulin (HBIG) 200u within 24h, a booster injection of hepatitis B vaccine (20ug) is required. 4, Hepatitis B occupational exposure personnel such as HbsAb (+), quantitative > 10 mIU/ml, then no preventive medication is required. As can be seen, it is not necessary to immediately inject hepatitis B immunoglobulin once occupational exposure to hepatitis B occurs, but it is necessary to decide which treatment plan to take according to the specific immunity of the exposed person’s body to the hepatitis B virus. In general, medical staff will undergo regular physical examinations in our hospitals, and the level of hepatitis B antibodies must be part of the examination, so it is normal for people at high risk of hepatitis B infection to know whether they have hepatitis B antibodies and their potency. Many medical personnel in major hospitals inject hepatitis B immunoglobulin immediately after occupational exposure, regardless of whether they have antibodies, even if they know they have been vaccinated against hepatitis B and have antibodies, they still “recklessly” inject globulin after occupational exposure, which is inappropriate.