C. Give an accelerated course of the hepatitis B vaccine + hepatitis B immune globulin – Explanation

Post-exposure prophylaxis

Hepatitis A

• Human Normal Immunoglobulin (HNIG) or hepatitis A vaccine may be used depending on the
  clinical situation

Hepatitis B

• HBsAg positive source: if the person exposed is a known responder to HBV vaccine then a booster
  dose should be given. If they are in the process of being vaccinated or are a non-responder they
  need to have hepatitis B immune globulin (HBIG) and the vaccine
• unknown source: for known responders the green book advises considering a booster dose of HBV
  vaccine. For known non-responders HBIG + vaccine should be given whilst those in the process of
  being vaccinated should have an accelerated course of HBV vaccine

Hepatitis C

• monthly PCR – if seroconversion then interferon +/- ribavirin

HIV

• a combination of oral antiretrovirals (e.g. Tenofovir, emtricitabine, lopinavir and ritonavir) as soon
  as possible (i.e. Within 1-2 hours, but may be started up to 72 hours following exposure) for 4 weeks
• serological testing at 12 weeks following completion of post-exposure prophylaxis
• reduces risk of transmission by 80%

Varicella zoster

• VZIG for IgG negative pregnant women/immunosuppressed

Estimates of transmission risk for single needlestick injury