hepatitis Flashcards
in a sexual health setting who should be tested for hepatitis A
(hep A total antibody)
MSMs
PWID
hep b or c positive
HIV +ve
when is someone with hepatitis A infective
2 weeks before to up to 1 week after developing jaundice
if a patient presents as a contact of hep A to someone who is known to have acute hep A how would you manage?
screen for hepatitis A (total antibody)
offer hepatitis A vaccine as PEP (if not known to be immune)
consider (if higher risk known hep b or c positive, age >50 or HIV positive) human normal immunoglobulin 250-500mg IM
who should be screened for hepatitis B
HIV +ve
MSMs
Sex workers
PWID
patients who have had sex with someone from a country where hep B more prevelent
sexual assault
needle stick injury
what hep b vaccine schedule do bashh recommend for at risk patients
ultra-rapid
0, 7,21 days and then booster at 12 months
if giving hep b vaccine when and how should you test for hepatitis B immunity?
Anti-HbS check 4-12 weeks after the last dose (12 month dose)
what % of patients will have hepatitis B immunity after three doses of the vaccine?
80%
80% of patients will have acquired hep b immunity after three vaccine doses, what % does this rise to just before having the fourth dose?
95%
if a patient is a non responder to one course of hep B vaccine what would your next step be
offer further course with 3 doses then recheck antibodies if there is a on going risk
what are the recommended hep B vaccine schedules for a patient who is HIV positive
double dose engerix (40 micrograms) or fenderix 0, 1, 2 and 6 months
(ideally avoid super accelerated)
check HbS ab 4-8 weeks post dose if < 10 offer second course, if 10-100 offer booster
>100 immune
in a HIV positive patient who has completed a course of hep b vaccine how do you manage
