1. Hepatitis B Medical, contextual & personal issues Bill Cayley MD MDiv

3. Facets of care Personal Contextual Medical

7. What is your assessment?

10. Hepatitis B serology Source: Centers for Disease Control (http://www.cdc.gov/ncidod/diseases/hepatitis/b/Bserology.htm) Four interpretations possible * Negative Positive negative HBsAg anti-HBc anti-HBs Chronically infected Positive Positive Negative Negative HBsAg anti-HBc IgM anti-HBc anti-HBs Acutely infected Positive Positive Positive Negative HBsAg anti-HBc IgM anti-HBc anti-HBs Immune due to hepatitis B vaccination** Negative Negative Positive HBsAg anti-HBc anti-HBs Immune due to natural infection Negative Positive Positive HBsAg anti-HBc anti-HBs Susceptible Negative Negative Negative HBsAg anti-HBc anti-HBs Interpretation Results Tests Interpretation of the Hepatitis B Panel

26. Hepatitis B immunization Source: http://www.immunize.org/catg.d/2081ab.htm 0, 1, 6 mos. 3 1.0 ml 10 µ g 20 years & older 0, 4–6 mos. 2 1.0 ml 10 µ g 11 thru 15 yrs. Infants: birth, 1–4, 6–18 mos. of age Alternative for older children: 0, 1–2, 4 mos. 3 0.5 ml 5 µ g 0–19 years Recombivax HB (Merck & Co.) 0, 1, 6 mos. 3 1.0 ml 20 µ g 20 years & older Infants: birth, 1–4, 6–18 mos. of age Alternative for older children: 0, 1–2, 4 mos. 3 0.5 ml 10 µ g 0–19 years Engerix-B (Glaxo-SmithKline) Schedule* # Doses Volume Dose Age group Vaccine Recommended dosages and schedules of hepatitis B vaccines

29. THANKS!