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Hepatitis B vaccination

Q: My father-in-law has been undergoing BiCarb Dialysis since January 2001. He was given the first dose of Hepatitis B vaccination but then we lapsed. Now again before renewing the immunization we got the Australia antigen test done and it came positive. What are the risk to the family members who stay with him? What are the precautions to be taken? What will be the future course of medication with my father in law.

A:Obviously your father in law developed hepatitis B infection before he could complete the vaccination. He needs to get his liver function test done along with HBV DNA & HBV e-antigen. All the close family members need to protect themselves by getting vaccinated. If his liver enzymes are abnormal & HBV DNA is positive, then he would need to be put on lamivudine. However, this would be best decided by his treating physician & by his hepatologist. Hope this clarifies all your queries.

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