Chapter·MicrobiologyHepatitis B/C

HBV vaccination and preventionDownloads

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1

A 35-year-old male anesthesiologist presents to the occupational health clinic after a needlestick exposure while obtaining an arterial line in a patient with cirrhosis. In addition to a standard bloodborne pathogen laboratory panel sent for all needlestick exposures at his hospital, additional hepatitis panels are ordered upon the patient's request. The patient's results are shown below: HIV 4th generation Ag/Ab: Negative/Negative Hepatitis B surface antigen (HBsAg): Negative Hepatitis C antibody: Negative Anti-hepatitis B surface antibody (HBsAb): Positive Anti-hepatitis B core IgM antibody (HBc IgM): Negative Anti-hepatitis B core IgG antibody (HBc IgG): Positive What is the most likely explanation of the results above?

AWindow period

BChronic infection

CAcute infection

DImmune due to infection

EImmune due to vaccination

2

A 52-year-old male patient with chronic alcoholism presents to an ambulatory medical clinic, where the hepatologist elects to perform comprehensive hepatitis B screening, in addition to several other screening and preventative measures. Given the following choices, which serologic marker, if positive, would indicate the patient’s immunity to the hepatitis B virus?

AHBeAb

BHBeAg

CHBsAb

DHBsAg

EHBcAb

3

A 28-year-old woman comes to the emergency department for a 1-week history of jaundice and nausea. She recalls eating some seafood last weekend at a cookout. She lives at home with her 2-year-old son who attends a daycare center. The child's immunizations are up-to-date, and his last hepatitis A vaccine was administered 6 weeks ago. The woman's temperature is 37.5°C (99.5°F), pulse is 82/min, and blood pressure is 134/84 mm Hg. Examination shows scleral icterus. The liver is palpated 2-cm below the right costal margin and is tender. Her serum studies show: Total bilirubin 3.4 mg/dL Alkaline phosphatase 89 U/L AST 185 U/L ALT 723 U/L Hepatitis A IgM antibody positive Hepatitis B surface antibody positive Hepatitis B surface antigen negative Hepatitis B core IgM antibody negative Hepatitis C antibody negative Which of the following health maintenance recommendations is most appropriate for the child at this time?

AIsolate the child

BAdminister hepatitis B immunoglobulin and hepatitis B vaccine

CNo additional steps are needed

DAdminister hepatitis B immunoglobulin only

EAdminister hepatitis A vaccine and hepatitis A immunoglobulin

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