A 19-year-old female has acute hepatitis B. Her male partner tested negative for HBsAg and anti-HBs but positive for anti-HAV. What is the best recommendation for him?

The most appropriate recommendation for the male partner in this scenario is the combination of hepatitis B vaccination and hepatitis B immunoglobulin. This is because he has been exposed to an acute hepatitis B infection through his partner, who is currently infected.

Receiving hepatitis B immunoglobulin within 24 hours of exposure can provide immediate passive immunity, helping to protect him from developing the infection. Additionally, the hepatitis B vaccination serves as active immunization, enabling the partner to build his own immunity against future infections. This combination approach is supported by guidelines that emphasize the importance of immediate post-exposure prophylaxis.

The need for both the vaccine and the immunoglobulin arises from the fact that while the partner tested negative for HBsAg and anti-HBs, indicating he is not currently infected and lacks immunity, the exposure puts him at risk for the acute infection. Administering both will offer the best chance of preventing hepatitis B infection and ensuring long-term protection.

In contrast, only providing either the vaccination or the immunoglobulin would not provide the comprehensive protection recommended after such exposure. Waiting to see if he becomes infected or assuming that no vaccination is needed at this time would not be appropriate, given the exposure risk.