TABLE 7.

Management of HBV in the exposed individual.

Hepatitis B status of source individual	HBV vaccination status of exposed individual
	Not vaccinated	Fully vaccinated, documented responder (HBsAb titre ≥ 10 mIU/mL)	Vaccinated, documented non-responder (HBsAb titre < 10 mIU/mL)	Vaccinated, HBsAb status unknown
HbsAg positive, or HbsAg unknown	Give HBIG, IM, 500 IU†	No action	Give HBIG, IM, 500 IU, then repeat after 1 month	Test exposed individual’s HBsAb‡:
	Initiate hepatitis B vaccine series		Re-initiate hepatitis B vaccine series (if not previously attempted)	If positive and titre ≥ 10 mIU/mL, no action
				If titre < 10 mIU/mL, give HBIG and hepatitis B vaccine booster, and recheck titre in one month
HbsAg negative	Initiate hepatitis B vaccine series	No action	Re-initiate hepatitis B vaccine series (if not previously been attempted)	Test exposed individual’s HBsAb:
				If positive and titre ≥ 10 mIU/mL, no action
				If < 10 mIU/mL, give hepatitis B vaccine booster and repeat titre after 1 month

Source: Adapted from National Guidelines for the Management of Viral Hepatitis. National Department of Health; c2019 [cited 2023 Jul 13]. Available from: https://knowledgehub.health.gov.za

HbsAg, hepatitis B surface antigen; HBIG, hepatitis B immunoglobulin; IM, intra-muscular; HBsAb, Hepatitis B surface antibodies.

^†HBIG and first dose of vaccine should be administered simultaneously, at different sites.

^‡If testing for HBsAb will be delayed for > 24 h, treat as non-responder.