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Hepatitis testing after occupational exposure

Nov 13, 1998

I read your response to a person who had begun pep [Post-Exposure Prophylaxis] for a occupational exposure and you stated that if the patient whose blood she was exposed to was high risk that she should be tested for HIV and Hep over the next six month period. There is all kinds of information out there about the HIV testing window, but how about Hepatitis? I had a possible exposure and a full series of test for B and C at 3 weeks after. Is it possible that I need to repeat these tests? Im at 9 weeks now. I know this isnt an HIV question, but I cant find the answer anywhere. Thank you.

Response from Mr. Sowadsky

Thank you for your question.

If you have had an occupational exposure to blood, it is very important to follow up with testing, not only for HIV, but for hepatitis B and hepatitis C as well.

If you were exposed to hepatitis B, and you were vaccinated against this virus, then it is recommended that you get tested immediately after the exposure, to make sure that you still have an immunity against the virus. If you still have immunity, then further testing (and treatment) for hepatitis B is usually not necessary.

If you were exposed to hepatitis B, and you were never vaccinated against this virus, or if blood tests show that you are not adequately immunized, then you should immediately be given immune globulin after the exposure, and begin the hepatitis B vaccination series (or be revaccinated if you were previously vaccinated but antibodies against the virus are no longer present). In this circumstance it is also recommended that you get tested for hepatitis B over the next 6 months.

If you were exposed to hepatitis C, you will need to get tested over the next 6 months (and perhaps even up to a year) after the exposure. Post-exposure prophylaxis (with drugs like Interferon) against hepatitis C is currently not recommended for occupational exposures to hepatitis C. There is no vaccine available against hepatitis C.

In regard to other types of hepatitis, it would be highly unlikely that you would become infected with hepatitis A or hepatitis E after a blood exposure, so testing for these viruses are usually not recommended under these circumstances. Testing for hepatitis D (Delta hepatitis) is usually not necessary, especially if you are not infected with hepatitis B (since hepatitis D is harmless in persons without hepatitis B). I am not aware of any testing guidelines for hepatitis G for occupational exposures at this time.

Since hepatitis B and hepatitis C are transmitted sexually, it is important that you use condoms with all of your sexual partners over the next 6 months (and perhaps even up to a year) after the exposure. Hepatitis B is much more infectious through sexual contact than hepatitis C, but hepatitis C can occasionally be transmitted sexually, primarily through intercourse.

It is also recommended that you do not donate blood, organs, or other body parts for one year following the exposure.

If you are showing any symptoms related to hepatitis (abdominal pain, flu-like symptoms, fatigue, jaundice, etc.) it is very important that you seek medical attention as soon as possible. But remember that the symptoms of hepatitis are similar to those of other illnesses, and not everyone has symptoms from these infections.

For a brief review of the different types of hepatitis and when symptoms appear, read the posting, What is viral Hepatitis, and how is it transmitted?.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

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