A HCW had a minor injury (wearing gloves) with a venous catheter needle of unknown origin. Her HBV state is: AntiHBc (+), HBsAg (-), antiHBs (-), HBeAg (-), antiHBe (-) (past infection with virus assumed cleared). Would you think there is need for antiHB immunoglobulin and/or vaccination?
Dear Dr Loupa,
First, if possible, I suggest to check the serology of the patient for which the catheter was used. Since the HCW has markers of past exposure to HBV, and the present serological marker status suggests that she has successfully cleared the past infection. In such a case, it is expected that any recent accidental exposure (the quantity of infecting virus, if present, is expected to be less, if the patient is not having a high viremia) in this case) to the virus will also be neutralized effectively. However it is still better to have anti HBs Ig as a counter-measure. Also, if possible follow the subject with a periodic serology and PCR for 3-4 months.
SD
Thank you Dr. Datta for your answer.
We did not know the patient for which the catheter was used. We decided not to use immunoglobulin - I don't know if this was the best decision. But for sure we will have a follow-up of the HCW.
CL
She had past hepatitis B infection with virus assumed cleared. However the source was unknown.
No HBIG is recommended. Follow up is all that required.
The serologic status is "core-only" which indicate past infection, current infection or a false positive reaction. I recommend test for HBV-DNA in any case, if you do not know for sure, that she have had a HBV-infection in the past.
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