Post-Exposure Prophylaxis

Question 1

Hepatitis A

Answer 1

Human Normal Immunoglobulin (HNIG) or hepatitis A vaccine may be used depending on the clinical situation

Question 2

Hepatitis B

Answer 2

• HBsAg positive source:
  
  • Known responder to HBV vaccine - HBV Booster.
  • Process of being vaccinated OR Non-responder - HBIG + HBV Vaccine
• Unknown source:
  
  • Known responders - Consider a HBV Booster.
  • Known non-responders - HBIG + vaccine
  • Process of being vaccinated - an accelerated course of HBV vaccine

Hep B Immune Globulin = HBIG

Question 3

Hepatitis C

Answer 3

Monitor with Monthly PCR test.

If seroconversion (found to have significant levels in blood) then interferon +/- ribavirin

Question 4

HIV

Answer 4

• A combination of oral antiretrovirals (e.g. Tenofovir, emtricitabine, lopinavir and ritonavir) as soon as possible
• Give within 1-2 hours, but may be started up to 72 hours following exposure)
• Give for 4 weeks
• Serological testing at 12 weeks following completion of post-exposure prophylaxis

Question 5

What dose post-exposure prophylaxis in HIV do to the risk of transmission?

Answer 5

Reduces risk of transmission by 80%

Question 6

Varicella zoster

Answer 6

VZIG for IgG negative pregnant women/immunosuppressed

Question 7

What are the estimates for viral transmission of different viruses by needle stick injury?

Answer 7

Hep B - 20-30%

Hep C - 0.5-2%

HIV - 0.3%