Prevention and control of perinatal hepatitis B virus transmission in ...

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Chen WH, Yin CS, Chang YK, Yan JS, Chu ML. Neonatal gastric aspirates as a predictor ofperinatal hepatitis B virus infections. Int J Gynaecol Obstet 1998; 60:15-21.Department of Obstetrics and Gynecology, Tri-Service General Hospital, National DefenseMedical Center, Taipei, Taiwan.The objective was to elucidate possible routes and predictors of perinatal transmission of hepatitisB virus (HBV). This was a prospective follow-up study. One hundred and forty-seven out of 1762pregnant women who were screened in the antenatal clinic of a university teaching hospital wereHBsAg carriers. Enzyme immunoassay was used for determination of hepatitis B markers.Occurrence of HBsAg in newborns' gastric aspirates, newborns' and infants' blood, and maternalmilk samples were determined. Their relationship with delivery routes and duration of the firststage of labor were analyzed by chi square test. The presence of HBsAg in newborns' gastricaspirates was strongly associated with the acquisition of HBsAg by the babies. There was nocorrelation between the rate of infant antigenemia and the duration of the first stage of labor, nordid cesarean section decrease the rate of vertical transmission of HBV. This is the first report toprovide direct evidence for the major role of the oral route in vertical transmission of HBV duringdelivery. In addition to maternal serum HBeAg, HBsAg status in newborn's gastric aspirates isanother important determinant for vertical transmission of HBV.Clements CJ, Baoping Y, Crouch A, Hipgrave D, Mansoor O, Nelson CB, Treleaven S, vanKonkelenberg R, Wiersma S. Progress in the control of hepatitis B infection in the WesternPacific Region. Vaccine 2006; 24:1975-1982.Centre for International Health, The Macfarlane Burnet Institute for Medical Research and PublicHealth Ltd., GPO Box 2284, Commercial Road, Melbourne, Vic. 3004, Australia.Hepatitis B virus infection is a serious problem globally, and particularly in the Western PacificRegion where the population suffers disproportionately from the infection and its sequelae. By2001, every immunization programme in the Region had included hepatitis B vaccine in theirschedule. However, many challenges remain if every one of the 26 million children born in the 37countries and areas of the Region each year is to be protected against hepatitis B infection. In2003, the Regional Committee of the World Health Organization's Western Pacific Regionresolved to improve hepatitis B control by making it one of two new pillars for strengthening theExpanded Programme on Immunization. The Committee endorsed the strategies of the RegionalPlan to improve hepatitis B control through immunization, reducing chronic HBV infection(chronic carriage rate) to less than 1%, and aiming for coverage of at least 80% of the birth cohortin every district with three doses of hepatitis B vaccine by 2005. To help guide this process, anassessment was made of the progress to date, and is reported in this paper. Coverage data used inthis evaluation were not independently verified, and could over-estimate progress made in somecountries. Whilst there has indeed been great progress in the Region, a number of nationalprogrammes still lack the ability to reach all children with immunization services. Other majorissues that need to be addressed are the challenges of delivering a timely birth dose, and for certaincountries, the affordability of the vaccine over the short- and long-term.Corrarino JE. Perinatal hepatitis B: update & recommendations. MCN Am J Matern Child Nurs1998; 23:246-252.Suffolk County Department of Health Services, Hauppauge, New York, USA.janecorrarino@yahoo.comThe hepatitis B virus (HBV) is the most prevalent chronic infectious disease in the world, andshould be better understood by nurses caring for families. Perinatal acquisition is the major cause12
of infection in infants and children. Without vaccine during infancy, 90% of infants born towomen positive for the virus will go on to become lifelong carriers. There are significant sequelaeassociated with HBV infection, ranging from fulminant HBV to chronic liver disease to anincreased risk for carcinoma. A comprehensive prevention and treatment strategy has beendeveloped by the Centers for Disease Control and Prevention, which includes screening of allpregnant women for the presence of HBV, the administration of hepatitis B immunoglobulin(HBIg) at birth, and the administration of hepatitis B vaccine at birth, at 1 month of age, and at 6months of age. Nurses working in the perinatal and pediatric specialties must understand theimplications of HBV to help prevent transmission and to assist in the coordination of care andadvocacy for affected populations. The community health implications for the care of women andchildren with HBV are clear, giving nurses the opportunity to develop a closer linkage betweenhospital- and community-based nursing practice.Da Villa G. Rationale for the infant and adolescent vaccination programmes in Italy. Vaccine2000; 18(Suppl 1):S31-S34.Italian Institute for the Prevention of Liver Diseases, Institute "Fernando de Ritis", Via GeneraleOrsini, 42-80132, Naples, Italy.In Italy in the 1980s, the incidence of acute hepatitis B was about 13 per 100,000, correspondingon average to 7500 new symptomatic cases per year was about 3%, making Italy an area ofintermediate endemicity. HBV infection was also associated with 12 per 100,000 deaths fromcirrhosis and with 5.1 per 100,000 deaths from hepatocellular carcinoma. In view of the largenumbers of pregnant women who were hepatitis B surface antigen (HBsAg)-positive, selectivehepatitis B vaccination of all newborns to these mothers and of other high-risk groups wasintroduced in 1983. Compliance was high among the newborns but low in other high-risk groups.Hepatitis vaccination was adopted in Italy in 1991, including each year all newborns, alladolescents aged 12 years and other high-risk groups. Compliance has been nearly 95% fornewborns and 80% for adolescents. Since the introduction of vaccination, both the incidence ofacute hepatitis B and the prevalence of HBV carriage have fallen, the latter from 3.4% in 1985 to0.9% in 1996. There is good evidence that these decreases are mainly the result of the vaccinationprogrammes. Although the full economic impact cannot yet be assessed, about 18,000 cases ofacute HBV infection have been prevented over the 6 years since starting the mass vaccinationprogramme, with cost savings of about US$ 244,308,000.Del Canho R, Grosheide PM, Schalm SW, de Vries RR, Heijtink RA. Failure of neonatalhepatitis B vaccination: the role of HBV-DNA levels in hepatitis B carrier mothers and HLAantigens in neonates. J Hepatol 1994; 20:483-486.Department of Internal Medicine II, University Hospital Dijkzigt, Rotterdam, The Netherlands.In a hepatitis B vaccination program (1982-1992), 705 infants born to HBsAg-positive mothersreceived HBIg within 2 h of birth and were vaccinated according to a three- or four-dosevaccination schedule, starting either at 3 months or directly after birth. Eight children HBsAgpositiveduring the first year of life (group 1: infected nonresponders). To determine whetherfailure of the hepatitis B vaccination was due to perinatal high-level maternal viraemia orgenetically determined infant nonresponsiveness to the vaccine, we measured HBsAg and anti-HBs levels in infants and HBeAg and hepatitis B virus-DNA levels in maternal serum, anddetermined the HLA type of the infants. Controls included 14 infants with a normal anti-HBsresponse 1 year after vaccination (group 2: noninfected responders) and all eight infants withoutHBsAg and anti-HBs 1 year after vaccination (group 3: noninfected low responders). HBsAg,HBeAg and anti-HBs were measured by radioimmunoassay (Abbott Laboratories), hepatitis Bvirus-DNA was measured quantitatively by solution hybridization for groups 1, 2, and 3 (Abbott13
Page 1 and 2: Pre-meeting documentPrevention and
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Page 5 and 6: prevalence was significantly higher
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Page 9 and 10: Boxall E. Screening of pregnant wom
Page 11: Chang MH, Hsu HY, Huang LM, Lee PI,
Page 15 and 16: Eriksen EM, Perlman JA, Miller A, M
Page 17 and 18: liver enzyme abnormalities than wer
Page 19 and 20: health care, is feasible and achiev
Page 21 and 22: HBsAg and anti-HBs in 4.5%. In the
Page 23 and 24: immunoprophylaxis. Reflecting effec
Page 25 and 26: Levin CE, Nelson CM, Widjaya A, Mon
Page 27 and 28: Delaying vaccination of premature i
Page 29 and 30: diagnosis. In the past, the inciden
Page 31 and 32: shows that the prevalence of HBV in
Page 33 and 34: Niu MT, Targonski PV, Stoll BJ, Alb
Page 35 and 36: Ranger-Rogez S, Alain S, Denis F. H
Page 37 and 38: vaccinees) and low reactogenicity o
Page 39 and 40: single ELISA test is about Rs40. At
Page 41 and 42: newborns with surface antigenemia,
Page 43 and 44: Wang Z, Zhang J, Yang H, Li X, Wen
Page 45 and 46: of hepatitis B vaccine. This study
Page 47 and 48: transmission has been estimated at
Page 49 and 50: at birth and 2 weeks after birth, f
Page 51 and 52: Chubinishvili OV, Mikhailov MI, Sak
Page 53 and 54: Jensen L, Heilmann C, Smith E, Want
Page 55 and 56: Onishchenko GG. Incidence of infect
Page 57: Zanetti A, Tanzi E, Semprini AE. He

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