Oo, pwede at dapat magpa-HBsAg testing agad, at kailangan ng immediate Hepatitis B vaccine at HBIG kung may exposure
Kung walang documented na Hepatitis B vaccination at may potential exposure sa HBV, kailangan ng immediate post-exposure prophylaxis na binubuo ng HBIG at Hepatitis B vaccine sa loob ng 24 oras, kasama ang HBsAg testing para malaman ang baseline status. 1, 2
Immediate Actions Pagkatapos ng Exposure
Testing Requirements
- Magpa-HBsAg at anti-HBs testing agad para malaman ang baseline infection at immunity status bago magbigay ng prophylaxis 2
- Ang testing na ito ay critical para malaman kung may existing infection na o may immunity na ba 1, 3
Post-Exposure Prophylaxis Protocol
Kung ang source ay HBsAg-positive at walang documented vaccination:
- Bigyan ng HBIG (0.06 mL/kg body weight) intramuscularly as soon as possible, preferably within 24 hours ng exposure 1, 4
- Simultaneously, bigyan ng first dose ng Hepatitis B vaccine sa separate anatomic site (halimbawa, different arm) 1, 2
- Ang effectiveness ng HBIG ay bumababa significantly kung ibibigay beyond 7 days, kaya ang 24-hour window ay critical 1, 4
- Ang combination ng HBIG at vaccine ay significantly mas effective (96% protection) kumpara sa HBIG alone (67% protection) based sa high-risk exposure data 5
Completion ng Vaccination Series
- Complete ang full 3-dose Hepatitis B vaccine series sa standard schedule: 0,1, at 6 months 1, 2
- Kung interrupted ang series, hindi na kailangan mag-restart—ituloy lang ang remaining doses 6
- Ang previously administered doses ay nananatiling valid at ang immune memory ay continuing 6
Follow-up Testing Protocol
Timing ng Post-Vaccination Testing
- Mag-recheck ng anti-HBs levels 1-2 months after completing the vaccine series para confirm ang protective immunity 7, 3
- Kung may HBIG na binigay, maghintay ng 4-6 months bago mag-test ng anti-HBs para hindi ma-interfere ng passively acquired antibodies from HBIG 7, 2
- Ang target protective level ay anti-HBs ≥10 mIU/mL 1, 7
Kung Non-Responder (anti-HBs <10 mIU/mL)
- Bigyan ng second complete 3-dose vaccine series 1, 6
- Retest 1-2 months after the third dose ng second series 6
- Kung still non-responsive after 6 total doses, test for HBsAg at anti-HBc para rule out chronic infection 1, 6
- Confirmed non-responders ay kailangan ng 2 doses ng HBIG (1 month apart) for future HBsAg-positive exposures 1, 6
Kung Unknown ang Source Status
Kung hindi alam kung HBsAg-positive ang source:
- Begin Hepatitis B vaccine series within 7 days ng exposure 4
- HBIG ay hindi routinely needed kung unknown ang source, unless high-risk source 1
- Complete ang full vaccination series regardless 1
Critical Pitfalls na Iwasan
- Huwag mag-delay beyond 24 hours para sa HBIG administration—ang effectiveness ay significantly bumababa 2, 4
- Huwag kalimutan na bigyan ng both HBIG and vaccine simultaneously kung HBsAg-positive ang source at unvaccinated ang exposed person 1, 2
- Huwag mag-test ng anti-HBs too early (before 4-6 months) kung may HBIG—makaka-detect ng false positive from passive antibodies 7, 2
- Huwag i-restart ang vaccine series kung interrupted—ituloy lang ang remaining doses 6
Additional Considerations
- Lahat ng healthcare workers with occupational exposure ay dapat din i-test for HIV, syphilis, gonorrhea, at chlamydia 2
- Ang hepatitis B vaccine ay very safe, with minimal adverse reactions limited to injection site symptoms 8
- Ang immune memory ay nananatili even when antibody levels decline, pero ang initial response documentation ay critical for healthcare workers 6, 3