Over the by 15 years, the use of hepatitis A and B vaccines every bit recommended by the Advisory Committee on Immunization Practices (ACIP) has resulted in a substantial reduction of cases of both types of viral hepatitis. In the US, an estimated 850,000-2.two million individuals are chronically infected with the hepatitis B virus and each year, approximately 30,000-50,000 cases of hepatitis A occur. New cases of hepatitis B infection in the United states of america had been decreasing until recently; however, in recent years, acute cases of hepatitis B have increased and there have been several outbreaks of hepatitis A.

This past year, two further concerns became evident: ane) under the influence of the national epidemic of opioid corruption, rates of hepatitis B in middle-aged adults really started to ascent and 2) outbreaks of hepatitis A accept occurred in several United states cities, oft amid homeless populations.

To help address the challenges surrounding hepatitis A and B in the US, the National Foundation for Infectious Diseases (NFID) hosted a webinar* in October 2017 and later developed responses to frequently asked questions:

Hepatitis A
Hep A
What is the recommended treatment for acute hepatitis A virus?
Unvaccinated individuals who have been exposed recently (within 2 weeks) to hepatitis A virus (HAV) should go hepatitis A vaccine or immune globulin to preclude astringent illness. There is no specific treatment for hepatitis A. Supportive intendance, such as fluids, nutrition, and rest, is also recommended.

How strict is the recommendation to administer the end dose of hepatitis A vaccine at 6 months? Are there information to support administering a 3rd dose if the 2d dose is administered within six months of the 1st dose?
A decreased immune response may occur when doses are administered earlier than the recommended interval. Doses of any vaccine administered ≥5 days earlier than the minimum interval or age should not be counted as valid doses and should be repeated as age advisable. The repeat dose should be spaced afterward the invalid dose past the recommended minimum interval. For example, if the offset and second doses of hepatitis A vaccine were administered less than 6 months autonomously, the second dose is invalid and should be repeated at least half dozen months after the invalid second dose.

Is at that place a take chances of reactivation of hepatitis A post-infection?
Reinfection of hepatitis A does non occur. Protective antibodies (IgG) develop in response to HAV infection and confer lifelong amnesty. Even so, relapsing hepatitis A has been described as an singular complication of hepatitis A virus infection.

Are there whatever current issues with hepatitis A vaccine supply on a national basis?
Yes, every bit of Nov 2017, in low-cal of ongoing outbreaks of hepatitis A among adults in several US cities, the demand for adult hepatitis A vaccine has increased substantially over the past 6 months and vaccine supply to meet this unexpected demand in the US has become constrained. The Centers for Disease Control and Prevention (CDC) website provides information on vaccine supply and shortages. Note that current constraints do non apply to the pediatric hepatitis A vaccine supply.

Hepatitis BHep B

Why should infants exist vaccinated confronting hepatitis B?
Approximately ninety% of infants who are infected with hepatitis B develop chronic hepatitis B infection and about i out of 4 infected babies will dice of liver failure or liver cancer every bit adults. All infants should exist vaccinated in the national effort to completely eliminate mother-to-infant transmission of hepatitis B.

What is the recommendation on boosters and titers with hepatitis B for healthcare professionals?
Healthcare professionals (HCPs) who may come into contact with blood or body fluids during their work should be educated and offered vaccination confronting hepatitis B. Anti-HBs testing should be performed ane-two months afterward administration of the last dose of the vaccine series. Completely vaccinated HCPs with anti-HBs <ten mIU/mL should receive an additional dose of hepatitis B vaccine, followed by anti-HBs testing 1-2 months later. HCPs whose anti-HBs remains <ten mIU/mL should complete the second series (usually 6 doses total), followed by repeat anti-HBs testing ane-ii months after the final dose. Alternatively, it might be more practical for very recently vaccinated HCPs with anti-HBs <10 mIU/mL to receive the second complete serial (usually six doses total), followed past anti-HBs testing 1-ii months after the final dose. CDC Guidance for Evaluating Health-Intendance Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management contains additional information. Once the vaccination and post-vaccination testing are complete, in that location are no recommendations for further periodic testing to appraise anti-HBs levels and in that location are no recommendations for routine boosting with hepatitis B vaccine.

For medical workers/students who nowadays without written evidence of hepatitis B vaccine serial, is the recommendation to titer or revaccinate (without a titer)?
HCPs defective documentation of hepatitis B vaccination should exist considered unvaccinated (when documentation for hepatitis B vaccine doses is defective) or incompletely vaccinated (when documentation for some hepatitis B vaccine doses is lacking) and should receive boosted doses to complete a documented 3-dose hepatitis B vaccine series.

Hepatitis (Full general)

Why are non-injection drug users at chance for hepatitis?
Individuals that prepare and use not-injection drugs are typically in settings where they may take lapses in personal hygiene which increases the likelihood of disease manual via shared equipment, drugs, or close personal contact.

If a pediatric patient receives an adult dose of either hepatitis A or B, do they need to be revaccinated?
No, however if the vaccine series is non complete, that individual should receive an age-appropriate dose at the adjacent recommended interval.

*NFID Webinar (CME/CNE): Hepatitis A and B Vaccines: Recommendations and Bear upon. Presented past Noele P. Nelson, MD, PhD, MPH, Medical Officeholder in the Sectionalisation of Viral Hepatitis at the Centers for Disease Command and Prevention (CDC). The webinar provides information on the immunogenicity and safety of hepatitis A and B vaccines, electric current ACIP recommendations, and the impact of vaccine implementation on the irresolute epidemiology of hepatitis A and B diseases.

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