Illness Prevention, Health Promotion, and Integrated Care — Occupational health

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Case 1 of 2Illness Prevention, Health Promotion, and Integrated CareOccupational health (e.g., needlestick injury)

A 27-year-old female surgical resident presents to the occupational health clinic 2 hours after sustaining a deep needlestick injury through her glove from a visibly bloody hollow-bore needle. The needle was used on a patient known to be hepatitis B surface antigen (HBsAg)-positive and hepatitis B e antigen (HBeAg)-positive. She washed the wound with soap and water immediately. She completed a 3-dose hepatitis B vaccine series as a student but has never had post-vaccination anti-HBs testing. She is healthy, takes no medications, has no known allergies, is not pregnant and weighs 60 kg.

Heart rate	78/min
Respiratory rate	14/min
Temperature	36.8 °C
O2 saturation	99%, room air
Blood pressure	112/68 mm Hg

Question 1 of 6

Which one of the following is the most appropriate management of her hepatitis B exposure at this time?

Select 1. (0 / 1 selected)

100%

AFull baseline HBV serology; defer treatment until results return

BRestart the 3-dose vaccine series only, without HBIG

CReassurance only, since the vaccine series was completed

DUrgent anti-HBs level; HBIG plus booster if below 10 IU/L

EEntecavir PO for 4 weeks

FTenofovir PO for 4 weeks

GHepatitis B vaccine booster IM now, without any testing

HHBIG IM now, without any testing or vaccine

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