Hepatitis B

Hepatitis B has a high needle-stick transmission risk and so is prevalent amongst the drug misusing population. Vaccination against this infection is now encouraged in order to reduce harm and reduce public health risks. It is important, however, to understand the Hepatitis B status of a client even where vaccination is offered since some clients who have previously contracted Hepatitis B remain infectious and some will not develop immunity after vaccination.

Initial screening for Hepatitis B can now be undertaken without the need for a blood sample. The OraSure^® collection device collects a non-invasive oral sample which is ideal to identify blood borne viruses as part of a screening programme.

	An initial antibody test (Anti –HBc) indicates whether a person has been infected with Hepatitis B and developed immunity.
	An initial antigen test (HbsAg) indicates whether a person is presently infected, and is likely to remain infectious.

This means that wider screening of high risk groups prior to vaccination can now be undertaken without taking blood and unnecessarily exposing health care workers to risk.

Anti-HBc and HbsAg would normally be found within 6 months or could be as soon as 4 weeks following exposure to Hepatitis B infection.

If positive, a second confirmatory test is required to confirm the identity prior to issuing the result. It is recommended that this second test is undertaken with a blood sample. This blood sample can be used to provide further testing.

If the person has received a previous vaccination course then a blood test for Hepatitis B surface antibody (Anti-HBs) will confirm status and check that there is still adequate immunity to provide protection.