Abstract | OBJECTIVE: To develop a guideline for the management of potential exposures to hepatitis B virus (HBV) at The Alfred Hospital, based on results of clinical audit, database analysis and literature review. METHODS: i) Retrospective record review of all histories of patients who received HBV immunoglobulin ( HBIG) at The Alfred between 1/1/2007 and 30/9/2011. ii) Analysis of HBV serological results of men who have sex with men (MSM) on Victorian NPEP Service (VNPEPS) database between 10/8/2005 and 31/12/2011. iii) Literature review to determine risks of HBV transmission and best practice for prevention of HBV transmission. RESULTS: A total of 48 patients were potentially exposed to HBV and given HBIG, with sexual exposure the most common indication (n=20). The source was reported to be HBsAg positive in one case only. Of the MSM on the VNPEPS database, 63% were immune to HBV, and only 0.5% of patients tested had evidence of chronic HBV infection. The recommendations for use of HBIG in The Australian Immunisation Guidelines are ambiguous and differ from other international guidelines. CONCLUSION: This audit at a tertiary referral hospital identified problems with the management of those potentially exposed to HBV. In those non-immune patients exposed to HBV, the combination of HBIG plus vaccination provides the best protection against infection. The risk of transmission of HBV is highly variable; rates of chronic HBV in PWID and MSM in Australia are low and do not warrant use of HBIG unless the source is known to be HBsAg positive.
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Authors | Anna B Pierce, Jude Armishaw, Stacey Aitchison |
Journal | Australian and New Zealand journal of public health
(Aust N Z J Public Health)
Vol. 37
Issue 5
Pg. 411-5
(Oct 2013)
ISSN: 1753-6405 [Electronic] Australia |
PMID | 24090322
(Publication Type: Journal Article)
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Copyright | © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia. |
Chemical References |
- Hepatitis B Surface Antigens
- Hepatitis B Vaccines
- Immunoglobulins
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Topics |
- Australia
- Evidence-Based Medicine
- Female
- Guidelines as Topic
- Hepatitis B
(diagnosis, prevention & control, transmission)
- Hepatitis B Surface Antigens
(blood)
- Hepatitis B Vaccines
(administration & dosage)
- Hepatitis B virus
- Humans
- Immunoglobulins
(administration & dosage)
- Male
- Medical Audit
- Retrospective Studies
- Tertiary Care Centers
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