Added new hepatitis B pathway resource leaflet. Booster doses are not recommended for people with normal immune status who have been vaccinated (Centers for Disease Control and Prevention. They rarely lead to drug resistance compared with other drugs, are simple to take (1 pill a day), and have few side effects, so require only limited monitoring.Entecavir is off-patent. A small subset of persons with acute hepatitis can develop acute liver failure, which can lead to death.In some people, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer.The likelihood that infection becomes chronic depends on the age at which a person becomes infected. CDC recommends hepatitis B vaccine for:Hepatitis B vaccine is safe and effective at preventing hepatitis B infections. Prevention of mother-to-child HBV transmission using antiviral therapy 89 10.3. Infant and neonatal hepatitis B vaccination 87 10.2. The mainstay of postexposure immunoprophylaxis is hepatitis B vaccine, but, in certain circumstances, the addition of HBIG provides increased protection (Adult populations with risk factors for HBV transmission or at risk for HBV reactivation should receive complete serologic testing (HBsAg, anti-HBs, and anti-HBc) so they can be appropriately counseled, vaccinated, and/or linked to care and treatment. Prevention of hepatitis B and C transmission in health-care settings 95 10.5. Tenofovir is no longer protected by a patent anywhere in the world. In high-income countries, surgery and chemotherapy can prolong life for up to a few years. In 2017, all low- and middle-income countries could legally procure generic entecavir, but the costs and availability varied widely. Serologic testing of hemodialysis patients and other immunocompromised people is recommended 1–2 months after administration of the final dose of the primary vaccine series to determine the need for revaccination. Hepatitis B is a liver infection caused by the hepatitis B virus. Post exposure prophylaxis guidance for hepatitis B are adapted from the Infants born to hepatitis B infected mothers are at risk of perinatal transmission. Most people do not experience any symptoms when newly infected. The major global routes of transmission are from mother to infant (perinatal), child to child (non-sexual person to person contact), sexual contact, and percutaneous exposure to blood or other infectious body fluids. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. Administering hepatitis B vaccine at the same time as other vaccines has not been shown to interfere with antibody response. In low-income settings, most people with liver cancer die within months of diagnosis. Of the three available adult vaccines for hepatitis B, there is limited safety data for HEPLISAV-B, and as such, providers should continue to vaccinate pregnant women needing hepatitis B vaccination with a vaccine from a different manufacturer. However, 90% of infants , 20% of older children, and 5% of adults develop a chronic infection. It is spread when infected blood, semen, or other body fluids enters the body of a person who is not infected. Added Hepatitis B vaccine advice for dental professionals. Until safety data are available for HEPLISAV-B, providers should continue to vaccinate pregnant women needing hepatitis B vaccination with a vaccine from a different manufacturer.Providers and patients can report administration of HEPLISAV-B to a pregnant woman to the HEPLISAV-B® Pregnancy Registry, an observational study being conducted in the United States to evaluate pregnancy outcomes in women vaccinated with HEPLISAV-B® within 28 days prior to conception or at any time during pregnancy. Disease is more severe among adults age >60 years (Approximately 25% of people who become chronically infected during childhood and 15% of those who become chronically infected after childhood die prematurely from cirrhosis or liver cancer, and most remain asymptomatic until onset of cirrhosis or end-stage liver disease (The risk for chronic infection varies according to the age at infection and is greatest among young children.