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Post-Exposure Prophylaxis after non-occupational and occupational exposure to HIV 

Australian National Guidelines (Third Edition)

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Last Updated: June 2023

Exposure to Other Conditions

Hepatitis B virus

All patients presenting for PEP should be assessed for HBV (see Table 4). 

HBV-negative individuals  

  • Individuals with evidence of previous immunity to HBV (HBsAb ≥ 10 IU ever documented following complete vaccination course, or past cleared infection who are immunocompetent) require no further follow-up 
  • Non-immune people (anti-HBc and HBsAb and negative) require HBV immunisation and follow-up (to six months)
  •  If the person is non-immune (HBsAb and HBcAb negative) and the source is known to have chronic HBV (HBsAg positive), follow Australian Immunisation Handbook guidelines.

HBV-positive (HBsAg-positive) people

  • People known to have or newly diagnosed with HBV infection on baseline testing can be safely commenced on HIV PEP
  • Refer to ASHM Decision Making in Hepatitis B tool.
  • As soon as possible after chronic HBV is identified, collect additional blood for:
    • HBeAg and anti-HBe
    • HBV DNA (quantitative)
    • Full blood count
    • Liver function test (LFT), international normalised ratio (INR) test and alpha fetoprotein (AFP) tumour marker test
  • Refer to a clinician experienced in managing HBV as soon as possible (and before completion of the 28-day HIV PEP course) for a decision about treatment discontinuation and follow-up.

Endorsed By

These guidelines are pending endorsement by the Blood Borne Viruses and Sexually Transmitted Infections Standing Committee (BBVSS).

Funded By: The Australian Government Department of Health
Disclaimer: Whilst the Australian Department of Health provides financial assistance to ASHM Health, the material contained in this resource produced by us should not be taken to represent the views of the Australian Department of Health.

The content of this resource is the sole responsibility of ASHM Health.

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