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

Rumi MA, Begum K, Hassan MS, Hasan SM, Azam MG, Hasan KN, Shirin M, Khan AK.Detection of hepatitis B surface antigen in pregnant women attending a public hospital fordelivery: implication for vaccination strategy in Bangladesh. Am J Trop Med Hyg 1998; 59:318-322.Department of Immunology, Bangladesh Institute of Research and Rehabilitation in Diabetes,Endocrine and Metabolic Disorders, Dhaka.Routine antenatal hepatitis B surface antigen (HBsAg) screening and immunization of risk babiesis very effective in preventing perinatal transmission of hepatitis B virus (HBV). We studied 1,800parturients attending a public hospital to assess the rationale for such vaccination in Bangladesh. Inone in every 29 deliveries (63 of 1,800 or 3.5%), the mother was found to be HBsAg positive. Allwere asymptomatic and many (41 of 63 or 65%) without risk factors would remain undetected ifHBsAg screening were performed on selected groups. Most of the HBsAg-positive mothers (54 of63 or 85.7%) were found to be chronic carriers and 30.2% (19 of 63) were also hepatitis B eantigen (HBeAg) positive, indicating high infectivity. Although 23 cord blood were positive forHBsAg or HBeAg, none were positive for IgM antibody to hepatitis B core antigen (IgM anti-HBc), suggesting transplacental transmission of the antigens rather than intrauterine infection.These findings are discussed in relation to the cost-effectiveness of routine prenatal screening andimmunization of risk babies compared with universal infant immunization.Sanpavat S, Poovorawan Y, Chittinand S, Bhongsvej S, Thaithumyanon P. Immunogenicityof hepatitis B vaccine in premature infants. Southeast Asian J Trop Med Public Health 1994;25:93-95.Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.The immunogenicity of plasma-derived hepatitis B vaccine was studied in 39 premature neonates,whose weights were 1,800-2,400 g and gestational ages 32-37 weeks. All maternal anti-HBcantibody were negative. Dosage of 5 micrograms of hepatitis B vaccine (Pasteur vaccine) wasgiven at 0, 1, 2 and 12 months after birth. At the ages of 1, 2, 4, 9, 12 and 13 months, anti-HBsantibody was found in 7.7%, 20%, 69.7%, 81.4%, 77.3% and 89.5%, respectively, while thegeometric mean titer in this seropositive group, starting at age 2 months was 37, 121, 113, 69 and1,016 mIU/ml. There was no severe reaction attributed to the vaccination. The result indicated thatthe vaccine was immunogenic. Although the conversion rate was low after primary injection, asatisfactory response developed at age 4 months after 3 doses of vaccine.Shakhgil'dian IV, Mikhailov MI, Khukhlovich PA, Anan'ev VA, Romanenko VV,Kuznetsova IO, Esaulkova AIu, Klimenko SM. The vaccinal prophylaxis of hepatitis B inRussia – the achievements, problems and outlook. Zh Mikrobiol Epidemiol Immunobiol 2000;2:44-49. [Article in Russian]Ivanovsky Research Institute of Virology, Gamaleya Research Institute of Epidemiology andMicrobiology, Moscow, Russia.Certain specific features of the present epidemic situation with hepatitis B (HB) in Russia wereestablished: significant growth of HB morbidity, starting from 1995; the prevalence of personsaged 15-29 years among HB patients, which was linked with the sharp activation of the sexualroute of the transmission of HB virus in recent years; an essential increase in the number ofpatients having contacted this virus in the process of the intravenous use of drugs. The results ofthe use of vaccine ‘Engerix B’ among persons belonging to different risk groups were considered(a decrease in HB morbidity among them by 8-19 times was noted), the study demonstrated highimmunogenicity anti-HBs antibodies on protective titers were determined in 92.3-95.7% of the36