Hep A and B Flashcards
At what age should children be vaccinated for Hep A?
age 1
who should be vaccinated against Hep A?
IVDU travelers MSM Health workers/Occupation anyone who wants immunity
what is route of transmission for Hep A? what type of virus is it DNA or RNA?
fecal oral route
RNA virus
What is dx of Hep A?
IgM against to HAV (anti-HAV)
What is tx for HepA?
supportive IgG anti-HAV: passive
limit acetominophen to 2g/day
NO ANTIVIRALS!
Which vaccine is given to children for Hep A? What is dosing schedule?
Harvrix
2 doses,
at age 1, and the 6- 12 months later
What is benefit for using VAQTA?What is dosing schedule for VAQTA?
preservative free
2 doses
0, 6-18 months
What is application of Twinrix? What is the dosing schedule?
adults only
3 doses= 0,1,6 months
combo A and B vaccine 4 doses= 0,7 days, 21-30 days, +12 mo
What are ADE of Hep vaccine?
injection site rxn soreness
HA
malaise
T/F There is a decrease in the efficacy of Hep A vaccine in people with HIV or immunocompromised or HepC
True
T/F There is a high seroconversion (94%) in Hep A first dose vaccine
True
What is pre exposure prophylaxis for pt <40 y/o? for >40y/o or immunocompromised?
- Can give vaccine 1 day before travel
2. give 2 weeks before and give IgG and Hep vaccine
What is post exposure prophylaxis protocol?
If no prior HAV vaccine given: vaccinate within 2 weeks after exposure to HAV
a) if ages 1-40 give HAV vaccine
b) if age <1 and >40 give HAV vaccine and IVIG
T/F IVIG to HAV alone is given only when vaccine cannot be used
TRUE
What is clinical use of IVIG?
- short term pre exposure coverage <3 months
- long term pre exposure prophlyaxis <5 months but requires a double dose
- post exposure prophylaxis
What are the administration sites of IVIG?
> 24 months: deltoid and butt
<24 months anterolateral thigh
What type of immunity if IVIG?
passive
what is route of transmission for hep b?
sexually transmitted
What determines chronic Hep B infection?
HBsAg present for > 6mo
What does loss of HBsAg mean?
immunity and clearance with anti-HBsAb
-patient got vaccine or developed ab to virus
What does loss of HBeAg mean?
- cleared infection with anti-HBeAg
- you only get this antibody from having had the virus
What is dosing schedule for adults for Hep B?
1mL : 3 doses
0, 1, 6 months
Engerix-B
Recombivax HB
What us dosing schedule for infants for Hep B?
.5 mL , 3 doses
0,1, 6
Engerix-B
Recombivax HB
T/F You cannot use combination vaccines like DTaP and HIB for infants at birth
TRUE
