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Hepatitis B post HBIG Injection
Jun 29, 2011

1) For someone who is HIV negative, was exposed to Hep B through sexual contact, was given their first of three vaccine shots at day 9, and the HBIG injection at day 11, how long should this person wait to have sexual activity? Put another way, how long would they be a potential risk to others, aside from the obvious need to wait 6-10 weeks to get tested. My understanding is that HBIG provides immediate immunity, and the neutralization of any existing virus in the individual.

2) Post-exposure treatment for the non-immunized is the first vaccine shot + HBIG. Then completing the vaccine shots. Are the remaining vaccine shots necessary to resolve the exposure risk? Or does the HBIG resolve it, and the remaining shots are just a logical next step...

3) I was told that HBIG lasts 3 months, and no other vaccinations should be taken during that time period. The 2nd vaccine shot falls within that time period. Should one get the 2nd shot a month later on schedule, or wait until 3 months for the 2nd shot?

4) If the exposed individual was already a carrier (positive HBsAg+) whether chronic or acute, what would happen if they did the full course of vaccine? Basically nothing?

Response from Dr. McGovern

After an exposure to hepatitis B infection, it is best to get HBIG as soon as possible. The effect of HBIG is to give passive antibodies, which will be immediately protective.

It is important to give HBV vaccine just to decrease the person's risk if exposed again. HBIG doesn't last but the vaccine does. There is no special schedule for the vaccine after HBIG.

There is also no major harm in getting vaccine if the person is HBV positive, but I would hope that baseline serologic testing was performed to determine need for the full series of vaccine since this has an associated cost.

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