October 13, 2010

USMLE 2 Question 8

You are asked to ensure that all your hemodialysis staff have appropriate prophylaxis against hepatitis B. One of the workers is not immunised.

Which agent would offer most appropriate prophylaxis?

a) recombinant hepatitis B vaccine
b) hepatitis B e antigen
c) Hepatitis B surface antigen
d) hepatitis C vaccine
e) hepatitis B immune globulin (HBIG)

The correct answer is A

Active immunization has become possible with the advent of hepatitis B vaccine. The original vaccine was prepared from the plasma of hepatitis B carriers. Although this vaccine underwent multistep inactivation that destroyed the infectivity of all known viruses (including HIV), concerns over the origin of the vaccine from high-risk persons limited its acceptance.

In 1987, a recombinant vaccine became available, derived from recombinant yeast into which the gene for surface antigen had been inserted. Such vaccines have replaced plasma-derived vaccines.

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