[Hepatitis B vaccine: simple and effective].

All workers in the dental office are at risk for hepatitis B infection. Hepatitis B has a chronic course in 10% of cases and may lead to liver cirrhosis, liver cancer and death. According to European law, approved in April 1994, employees have to be protected against biological agents in their working environment. The employer has to offer vaccination, free of costs, in case of risk for infection with hepatitis B. The vaccination scheme consists of three doses. Vaccination is successful if the antibody-titer (anti-HBs) is higher than 100 IU/L. Excellent immune memory is then formed, giving protection for more than 10 years. Testing of anti-HBs or revaccination is not necessary during that period of time. Up to three additional vaccinations should be given if the anti-HBs titer remains below 100 IU/L; if the anti-HBs remains lower than 10 IU/L, there is no protection against hepatitis B. Someone with a titer between 10 and 100 IU/L is protected (if the titer was measured twice), but it is still unknown how long protection will last. Revaccination is recommended if the titer falls below 10 IU/L at any time. The policy after a needle-stick accident with HBsAg positive material is determined by the question whether a person has ever had an adequate reaction to hepatitis B vaccination (i.e. anti-HBs > 100 IU/L). If this is the case, no action is needed. If not, passive-active vaccination has to be given, by hepatitis B immunoglobulin (HBIg) and hepatitis B vaccination.