Topic: Post-exposure Prophylaxis Hepatitis B
Description
Post-exposure prophylaxis (PEP) is treatment that can be used after possible exposure to the Hepatitis B virus through sex, drug injecting equipment or injury such as needle stick injury. PEP is given to decrease the risk of infection with the Hepatitis B virus. It does not reduce the risk of other sexually transmissible infections or infection with blood-borne viruses including Hepatitis C.
Do's
Hepatitis B vaccination provides long term protection against hepatitis B.
If there has been an incident in which a person may have been exposed to the Hepatitis B virus, they should go to their local doctor, family planning clinic, sexual health clinic or local public hospital as soon as possible, preferably within 24 hours. If the delay is longer than three days, PEP is not effective.
The best ways to avoid infection with the Hepatitis B virus and other blood-borne and sexually transmissible infections include:
- safe sex, including consistent and correct use of condoms every time
- not having sex
- not using intravenous drugs
- if you do use intravenous drugs, always use sterile equipment and don’t share any equipment.
Tips
Post-exposure prophylaxis can be used in emergency situations where there has been a failure in usual precautions and there may be a risk of exposure to hepatitis B. Examples are:
- occupational exposure for health care workers
- broken condom
- sexual assault
- unprotected sex whilst intoxicated
- finding out a needle-sharing person may have hepatitis B
- needle stick injury in a public place.
It is natural for people in this situation to be very anxious. The treating doctor will provide information and support.
The doctor will also assess the risk of exposure. This depends on:
- what is known about the other person or persons (the person or persons who are the source of possible infection):
- is the person known to be infected with hepatitis B?
- is the person known to be at risk of infection with hepatitis B?
- can the person be contacted?
- will the person consent to testing?
At that first visit to the doctor or clinic, blood tests will be done. There are no tests which can show whether a person has been infected with hepatitis B or any other infection from an exposure within the past couple of days. Those first blood tests are done to check whether that person has any sign of infection with or immunity to Hepatitis B virus.
Tests will be repeated at six weeks, three months and six months. After infection with hepatitis B, it may take some time for the infection to show up in blood tests. This is called the window period. The window period for hepatitis B it is six months. A person cannot be sure there is no infection until tests at those times are completed.
If there is a risk of exposure to Hepatitis B virus, PEP for hepatitis B would be recommended.
If there is a risk of pregnancy, women should ask the doctor or health worker about emergency contraception.
The risk of infection with Hepatitis C virus and sexually transmissible infections should also be considered. Tests can be done if necessary.
Until tests and follow-up are completed:
- do not donate blood, breast milk or semen
- have safe sex
- do not share intravenous drug equipment
- seek advice from the doctor about pregnancy and breast feeding.
Hepatitis B
Blood tests can show whether a person has immunity to Hepatitis B virus. This could be from past infection or from immunisation. If there is no immunity, an injection of immunoglobulin can be given. This provides protection against recent accidental exposure to Hepatitis B virus. Hepatitis B immunoglobulin does not provide long term protection against Hepatitis B virus.
Hepatitis B vaccination is recommended as safe and effective long term protection against Hepatitis B virus. It is given as three injections over six to 12 months.
Practical Advice
For more information about post-exposure prophylaxis, you can talk to:
- your local doctor
- your local sexual health clinic
- your local family planning clinic
- your nearest public hospital. They will be able to give you the phone number of the nearest sexual health clinic if they are unable to provide PEP. All major public hospitals should be able to provide PEP through the Accident and Emergency Department.
- Queensland Hepatitis Council
Other Resources
Queensland Health - Sexual Health website
Related Content
Post-exposure Prophylaxis – HIV fact sheet
Safe sex fact sheet
Condom Use fact sheet
Emergency Contraception fact sheet
Last updated: 13th October, 2009
Review Date: 30th June, 2010
