20th February 2024

Hepatitis B

Recipients exposed towards hepatitis B should be assessed for their vaccination status and previous hepatitis B status. It is also essential to know if the recipient is known to have responded to their hepatitis B vaccine if this had been taken. 

The timings and exact blood tests needed may vary between health boards, but NICE recommends blood to be taken at four intervals: baseline, 4-6 weeks, three months and six months post-exposure. HBsAg, anti-HBs and anti-HBc have been used to monitor the development of hepatitis B in this group.

Treatment can be provided using passive immunisation. Recipients known to have developed immunity towards hepatitis B via previous infection or successful vaccination do not require immunoglobulin treatment. NICE recommends administering a booster dose following significant exposure unless the patient has received a booster dose within four weeks of exposure. 

In recipients without proven hepatitis B immunity, post-exposure prophylaxis is indicated, provided with the hepatitis B vaccination and immunoglobulin. For most cases, the accelerated hepatitis B schedule is given with vaccines given at 0,1- and two months post-exposure. Their antibody titres should be checked within 1-4 months following completion of their vaccine course. NICE recommends the administration of immunoglobulin in this group of patients, but this should be discussed with the microbiologist before administration.