B Positive – all you wanted to know about - ASHM

5 Primary prevention of hepatitis B virus infection
be given, as a fourth double dose or further
three doses at monthly intervals, followed by
testing for response four weeks later. Persistent
non-responders should be informed about the
need for HbiG within 72 hours of parenteral
exposure to HbV.
Vaccination failure may occur in people
exposed to HbV variants with mutations
in the HbV surface gene (vaccine-induced
escape mutant). current HbV vaccines are not
effective in preventing infection with these
mutants. the majority of such vaccine-induced
escape mutants were initially reported in
neonates through vertical transmission and in
transplant recipients. these vaccine-induced
escape mutants were responsible for most of
the 3.4% vaccine failure rate reported in the
chinese adult population undergoing an HbV
vaccination program. 10
HBV vaccination programs in the
CALD and Indigenous populations
caLd and indigenous populations are
confronted with different issues from the
general population, which often hamper the
success of vaccination programs in australia.
Language and cultural differences are obvious
barriers. People not captured by the universal
infant and adolescent vaccination program
can present, related to their age at migration
to australia. some practices transferred to
australia, such as eyebrow tattooing and
vacuuming (a form of therapy involving the
use of suction cups applied to the skin), could
continue to be routes of transmission.
the high prevalence rate of HbV infection in
the indigenous population requires targeted
public health policies to overcome the barriers
to accessing public health education and
medical services.
for further information about these
recommendations, please refer to The Australian
Immunisation Handbook. 9th edition (2007). 11
References
50 b Positive – all you wanted to know about hepatitis b: a guide for primary care providers
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2006. available at: http://www.who.int/
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(Last accessed october 2006).
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(12); 1373–7.
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