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

Reductions of HBV DNA in both treatments were significant (P < 0.05). The rate of neonatalintrauterine HBV infection was significantly lower in HBIg group (16.1 %) and lamivudine group(16.3 %) compared with control group (32.7 %) (P < 0.05), but there was no significant differencebetween HBIg group and lamivudine group (P > 0.05). No side effects were found in all thepregnant women or their newborns. The risk of HBV intrauterine infection can be effectivelyreduced by administration of HBIg or lamivudine in the 3rd trimester of HBsAg positive pregnantwomen.Lin HH, Wang LY, Hu CT, Huang SC, Huang LC, Lin SS, Chiang YM, Liu TT, Chen CL.Decline of hepatitis B carrier rate in vaccinated and unvaccinated subjects: sixteen years afternewborn vaccination program in Taiwan. J Med Virol 2003; 69:471-474.Department of Gastroenterology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.hoholin@ms10.hinet.netTaiwan was an endemic area for hepatitis B virus (HBV) infection, and related liver diseases causea significant drain of public resources. To control the endemic, a nation-wide newborn vaccinationprogram was started in 1985. We reviewed the results of the annual survey for HBV surfaceantigen (HBsAg) performed in freshmen class of two high schools in Hualien, eastern Taiwan,from 1991 to 2001. A total of 10,194 students, most of them 15 years old, were tested for serumHBsAg using enzyme immunoassays. There is a significant trend (P < 0.0001) of decreasingHBsAg carrier rate from 20.3 to 4.4% in males and 14.3% to 2.4% in females, respectively, over11 years. The HBsAg carrier rate was 16.0-20.3% in students surveyed during 1991-1993 (bornmore than 6 years before the start of the national vaccination program), which decreased to 7.7-11.9% during 1994-1999 (born 1-6 years before the program). It further declined to 4.7% and3.4% in 2000 and 2001 (born after the start of the program). The HBsAg carrier rate in malestudents was significantly higher than that in female students in most of the years. The HBVnewborn vaccination program not only successfully prevented most of the perinatal transmissionof HBV but also reduced horizontal transmission of HBV to children born up to 6 years before thestart of the program. Also, the protection persisted for at least 15 years.Linder N, Vishne TH, Levin E, Handsher R, Fink-Kremer I, Waldman D, Levine A,Ashkenazi S, Sirota L. Hepatitis B vaccination: long-term follow-up of the immune response ofpreterm infants and comparison of two vaccination protocols. Infection 2002; 30:136-139.Dept. of Neonatology, Schneider Children's Medical Center of Israel, Petah Tiqva.linderm@netvision.net.ilWe conducted a 3-year follow-up study of long-term antibody persistence following vaccination oflow-risk preterm infants with recombinant hepatitis B vaccine (HBV). Two three-dose protocolswere compared: vaccination beginning within 24 h of birth to initial vaccination delayed until aweight of 2,000 g was reached. The study population included 136 children, divided into threegroups: children born prematurely (< or = 35 weeks, n = 57), children born at term (> or = 37weeks, n = 39), both groups receiving the first dose of HBV within 24 h of birth, and children bornprematurely (< or = 35 weeks, n = 40), who received the first dose of HBV when a weight of 2,000g was reached. All infants received the second hepatitis vaccination 1 month after the first, and thethird dose 6 months after the first. Hepatitis B surface antibody (AntiHBs) was measured at an ageof 3-3.5 years (at least 2.5 years after completion of the three-dose HBV series). An AntiHBs levelof > or = 10 IU/l was considered positive. At 3-3.5 years of age, a higher percentage of thepremature-delayed vaccination group had a positive AntiHBs level (92.5%) compared to both thepremature (54.4%, p < 0.001) and full-term groups (71.8%, p < 0.05) vaccinated soon after birth.The premature-delayed vaccination group also had a significantly higher geometric meanconcentration (GMC) (119 vs 14.2 IU/l, p < 0.001 and 119 vs 32.7 IU/l, p < 0.005, respectively).26