Hepatitis A B E

Hepatitis A is a common problem in rural areas of developing countries. There is a declining level of antibodies to hepatitis A in developed countries and adults are at special risk; so 1 or 2 doses of hepatitis A vaccine should be given. If there is insufficient time a single injection of human immunoglobulin (IG) can give protection for 3 to 6 months. It is safe for all age groups but children under 8 years should not need it. A blood test for hepatitis A antibodies should be carried out to determine a person's immunity.

Prevention

• The rules of avoiding contaminated food and water apply (as for traveller's diarrhoea).

Hepatitis B is endemic in South-East Asia, South America and other developing countries. Vaccination is recommended especially for people working in such countries, particularly those in the health care area or those who may expect to have sexual or drug contact. If patients have a 'negative' HBV core IgG titre, then vaccination would be worthwhile (3 doses: 0, 1 and 6 months). Hepatitis E has a high mortality rate in pregnant women.

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