Treatment Plan & Prognosis

Treatment Plan

1. Systemically unwell: Hospital admission
2. Specialist referral for treatment/monitoring
3. Pre-treatment bloods
4. Public health measures:
– Acute (notifiable) or Chronic (not notifiable)
5. Immunisation:
– Pregnant carriers: infant immunisation at birth
– Post-exposure: IVIG + vaccine within 48hrs (if exposure <7 days)
– Rapid immunisation: 3 doses over 21 days
– Standard immunisation: 3 doses over 2 months
– For Occupational: Antibody titre aim >100 post immunisation. If 10-100, consider repeating immunisation. If <10, then check Anti-Hbc & give another dose

Prognosis

15-20% of chronic cases develop cirrhosis, 10% of cirrhosis cases develop HCC
– Chronic infection risk is higher with vertical transmission