In a 3-year-old with hepatitis A exposure, what is the recommended management?

In a 3-year-old with hepatitis A exposure, what is the recommended management?

• A. HAV vaccine
• B. Immunoglobulin G
• C. Interferon-alfa
• D. Supportive care

Answer: (D)

After exposure to hepatitis A, the goal is to prevent infection with post-exposure prophylaxis rather than waiting to treat illness later. The best approach is to provide post-exposure prophylaxis within about 14 days of exposure, using the hepatitis A vaccine or, in certain situations, immune globulin. For a healthy 3-year-old, the preferred option is a hepatitis A vaccine given promptly as PEP; immunoglobulin is an alternative when vaccine administration isn’t suitable or the child is at higher risk (for example, due to age below 12 months, immunocompromise, or chronic liver disease). Interferon-alfa has no role in HAV prophylaxis or acute treatment. Supportive care is important if an actual infection develops, but it does not prevent disease after exposure.

After exposure to hepatitis A, the goal is to prevent infection with post-exposure prophylaxis rather than waiting to treat illness later. The best approach is to provide post-exposure prophylaxis within about 14 days of exposure, using the hepatitis A vaccine or, in certain situations, immune globulin. For a healthy 3-year-old, the preferred option is a hepatitis A vaccine given promptly as PEP; immunoglobulin is an alternative when vaccine administration isn’t suitable or the child is at higher risk (for example, due to age below 12 months, immunocompromise, or chronic liver disease). Interferon-alfa has no role in HAV prophylaxis or acute treatment. Supportive care is important if an actual infection develops, but it does not prevent disease after exposure.