# HBV Exposure Action Tool

After a needle stick, blood contact with broken skin or mucous membranes, shared sharp object, or possible sexual exposure, organize what to do now and what to ask a clinician. This tool does not decide whether HBIG, vaccination, or testing is required.

This tool is only for organizing exposure information and preparing for care. It does not decide whether you personally need HBIG, vaccine, or specific tests. Please consult a qualified clinician, emergency department, occupational exposure service, or public health office promptly.

- Organize the exposure type, timing, source HBsAg status, and your vaccine and anti-HBs records.
- Flag situations where you should promptly contact a clinician, emergency department, occupational exposure service, or public health office.
- Create a record and follow-up question list to bring to care.

## Inputs

- Exposure type (exposure_type): needle=Needle stick, cut, or sharp injury; blood_open_skin=Blood contact with broken skin; mucous_membrane=Blood or body fluid contact with eyes or mouth; sexual=Possible sexual exposure; shared_sharp=Shared needles, razor, tattoo needle, or other sharp object; other=Other or not sure
- Source person's HBsAg status (source_status): positive=Known HBsAg positive; negative=Known HBsAg negative; unknown=Unknown or cannot confirm
- Your hepatitis B vaccine record (vaccination_status): complete=Completed full vaccine series; incomplete=Started but not completed; none=Never vaccinated; unknown=Not sure
- Your anti-HBs result (anti_hbs_status): at_or_above_10=anti-HBs >=10 mIU/mL; below_10=anti-HBs <10 mIU/mL; not_tested=Never tested; unknown=Not sure
- Time since exposure (time_since_exposure): less_24h=Within 24 hours; one_to_seven_days=1-7 days; more_than_seven_days=More than 7 days; unknown=Not sure
- Exposed person (exposed_person): adult=Adult; healthcare_worker=Healthcare, lab, or care worker; pregnant=Pregnant or possibly pregnant; infant=Infant or newborn

## Exposure preparation checklist

### emergency_priority

- You selected a possible HBV exposure. Contact a clinician, emergency department, occupational exposure service, or public health office promptly; do not wait for symptoms.

### time_priority

- Post-exposure decisions are time-sensitive. If the exposure just happened or timing is unclear, ask promptly whether vaccine, HBIG, or follow-up testing is needed.

### source_priority

- If the source person is HBsAg positive or unknown, bring source information, exposure timing, and your immune records for assessment.

### vaccine_priority

- If vaccine records or anti-HBs protection are unclear, ask promptly whether vaccination, repeat vaccination, HBIG, or repeat testing is needed.

### baseline_priority

- Record the time, exposure route, visible blood, and known HBV testing or vaccine information for both people.

### baseline_actions

- Record the time, place, tool or contact route, visible blood, wound, and mucous membrane contact.
- Do not wait for fever, jaundice, or abnormal liver tests; HBV post-exposure care depends on timing and immune records.

### skin_actions

- For needle stick, cut, or blood contact with broken skin, wash with running water and soap; avoid repeated harsh chemical scrubbing.

### mucous_actions

- If blood or body fluid entered the eyes or mouth, rinse with clean water and seek medical advice promptly.

### sexual_actions

- For possible sexual exposure, record timing and the partner's known HBsAg status, and ask about HBV post-exposure care and other STI testing.

### baseline_discussion

- Ask the clinician to consider the exposure route, source HBsAg status, your vaccine record, and your anti-HBs result.
- Ask whether baseline or follow-up HBsAg, anti-HBs, anti-HBc, HBV DNA, or liver tests are needed.

### pep_discussion

- If the source is HBsAg positive or unknown and you are unvaccinated, incompletely vaccinated, unsure, or have low anti-HBs, discuss HBIG and hepatitis B vaccine steps promptly.

### protected_discussion

- Completed vaccination plus a documented anti-HBs >=10 mIU/mL usually indicates evidence of protection. Still keep the exposure record and ask whether any scenario-specific action is needed.

### pregnancy_discussion

- Pregnancy, infant, or newborn exposures should involve obstetric, pediatric, infectious disease, or liver clinicians promptly.

### bring

- Your hepatitis B vaccine dates and past anti-HBs quantitative results.
- Your HBsAg, anti-HBc, anti-HBs, HBV DNA, or liver test reports.
- The source person's known HBsAg or HBV test results; if unknown, say unknown.
- Exposure time, route, tool photos or incident record, and whether washing or rinsing was done.

### baseline_follow_up

- Ask the clinician to write down follow-up dates, tests, and who to contact.

### testing_follow_up

- If the source is positive or unknown, ask whether baseline and later HBsAg, anti-HBc, anti-HBs, or liver tests are needed.

### vaccine_follow_up

- If vaccination or revaccination is recommended, record each dose date and confirm when anti-HBs should be checked.

### urgent

- Needle stick, blood contact with broken skin or mucous membrane, shared sharp objects, or possible sexual exposure should be discussed with a professional promptly.
- Severe wounds, ongoing bleeding, or other urgent risks should be handled as emergency care.

## Evidence basis

- [CDC Hepatitis B Prevention and Control](https://openhbv.com/sources/cdc-hepatitis-b-prevention-and-control.md?locale=en) — https://www.cdc.gov/hepatitis-b/prevention/index.html
- [CDC Hepatitis B Testing and Diagnosis](https://openhbv.com/sources/cdc-hepatitis-b-testing-and-diagnosis.md?locale=en) — https://www.cdc.gov/hepatitis-b/hcp/diagnosis-testing/index.html
- [CDC Hepatitis B Vaccine Administration](https://openhbv.com/sources/cdc-hepatitis-b-vaccine-administration.md?locale=en) — https://www.cdc.gov/hepatitis-b/hcp/vaccine-administration/index.html
- [CDC Responding to HBV Exposures in Health Care Settings](https://openhbv.com/sources/cdc-responding-to-hbv-exposures-in-health-care-settings.md?locale=en) — https://www.cdc.gov/hepatitis-b/hcp/infection-control/index.html
- [WHO Hepatitis B Fact Sheet](https://openhbv.com/sources/who-hepatitis-b-fact-sheet.md?locale=en) — https://www.who.int/news-room/fact-sheets/detail/hepatitis-b