Post-exposure management of personnel after occupational percutaneous and mucosal exposure to blood and body fluids

Anti-HBc: antibody to hepatitis B core antigen; anti-HBs: antibody to hepatitis B surface antigen; HBIG: hepatitis B immune globulin; HCP: health care personnel; HBsAg: hepatitis B surface antigen.
* HBIG should be administered intramuscularly as soon as possible after exposure when indicated. The effectiveness of HBIG when administered >7 days after percutaneous, mucosal, or nonintact skin exposures is unknown. HBIG dosage is 0.06 mL/kg.
¶ Should be performed one to two months after the last dose of the hepatitis B vaccine series (and four to six months after administration of HBIG to avoid detection of passively administered anti-HBs) using a quantitative method that allows detection of the protective concentration of anti-HBs (≥10 milli-international units/mL).
Δ A responder is defined as a person with anti-HBs ≥10 milli-international units/mL after completing the hepatitis B vaccine series.
◊ A complete series usually consists of three doses administered at 0, 1, and 6 months, but a four-dose accelerated series may have been provided or a two-dose series of Heplisav-B. Refer to the topic that discusses hepatitis B immunization in adults for additional information on hepatitis B vaccination.
§ A nonresponder is defined as a person with anti-HBs <10 milli-international units/mL after completing two hepatitis B vaccine series.
¥ HCP who have anti-HBs <10 milli-international units/mL, or who are unvaccinated or incompletely vaccinated and sustain an exposure to a source patient who is HBsAg positive or has unknown HBsAg status, should undergo baseline testing for HBV infection as soon as possible after exposure, and follow-up testing approximately six months later. Initial baseline tests consist of total anti-HBc; testing at approximately six months consists of HBsAg and total anti-HBc.