2008BASHH甲、乙、丙型病毒性肝炎管理指南
《2008BASHH甲、乙、丙型病毒性肝炎管理指南》內(nèi)容預(yù)覽
Partner notification should be performed for atrisk homosexual contacts (oro/anal, digital/rectal and penetrative anal sex) within the period two weeks before to one week after the onset of jaundice. This to be documented and the outcome documented at subsequent followup. Other people thought to be at risk (household contacts, those at risk from food/water contamination ) to be contacted via the public health authorities (consultant in communicable control (CCDC) or equivalent). The CCDC has a duty of confidentiality to the index patient.
Hepatitis A vaccine may be given up to 14 days after exposure providing exposure was within the infectious period of the source case (during the prodromal illness or first week of jaundice) (Ib, A)
Human normal immunoglobulin (HNIG) 250500 mg. intramuscularly should also be considered for patients at higher risk of complications (concurrent chronic hepatitis B or C, chronic liver disease or age >50 yo) (Ib, A)
HNIG that is effective against HAV is in short supply in the UK and can only be obtained from the Heath Protection Agency (England and Wales), Health Protection Scotland or the Northern Ireland Public Health Laboratory Belfast
HNIG works best if given in the first few days after first contact with an efficacy of 90% and is unlikely to give any protection more than two weeks after first exposure, but may reduce disease severity if given up to 28days after exposure
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