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3.4: Hepatitis B

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    In October of 2011 the ACIP began recommending Hepatitis B vaccine in non-immunized diabetic patients under the age of 60.6 Patients with diabetes have greater than two fold increased risk of developing acute HBV when compared to non-diabetic patients. Diabetics are also more likely to develop NASH which increases morbidity and mortality associated with HBV. Despite these guidelines, screening for Hepatitis B is often missed in the primary care setting. Therefore physicians need to make a practice of screening for Hepatitis B vaccination especially in diabetic patients.

    What to know in clinic:

    Administer missing doses to complete a 3 dose series (0, 2, 4 months)

    If the series is delayed, complete the series from prior dose

    Check a titer 1 month after a 3 dose series, repeat series if <10 IU


    Anyone can be vaccinated but specific indications include the following:

    • sexually active patients not in long-term monogamous relationship 
    • patients seeking evaluation for STDs
    • current or recent injection drug users
    • men who have sex with men
    • health care personnel potentially exposed to blood or body fluids
    • diabetics <60 (under physician discretion when over age 60)
    • ESRD, chronic hemodialysis patients
    • chronic liver disease
    • HIV
    • household contacts and sexual partners of Hep B surface Ag positive persons
    • travelers to regions of high endemic HBV infection
    • adults in the following settings: STD treatment, HIV testing/treatment, drug abuse treatment/prevention, correctional facilities, ESRD programs, developmental
      disability facilities


    3.4: Hepatitis B is shared under a not declared license and was authored, remixed, and/or curated by LibreTexts.

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