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

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was to describe the responses of infants born to HBeAg-negative carrier mothers receiving HBIgcombined with hepatitis B vaccine. Term babies born to HBeAg-negative carrier mothers wereassigned based on chart number to 1 of the 2 treatment groups. Group A infants (n = 94) received0.5 ml (145 IU) of HBIg within 24 h of birth and 3 subsequent doses of recombinant hepatitis Bvirus (HBV) vaccine at 3 to 5 days, 1 month and 6 months of age. Group B infants (n = 122)received 3 doses of vaccines only. Infants (n = 19) born to HBeAg-positive carrier mothers weretreated like those in Group A and are referred to as Group C. Sera obtained from infants at 2 and 7months of age were tested for hepatitis B virus (HBV) markers. There were 2 (1%; one in Group Aand one in Group B) subclinical breakthrough hepatitis B infections among studied infants. One(5%) child of Group C had asymptomatic HBV infection at the age of 7 months and became achronic carrier. The rate of protective anti-hepatitis B surface antibody (anti-HBs) titers achieved(> 10 mIU/ml) by 2 months of age was significantly higher in Group A than that in Group B (98%vs. 57%, P < 0.001). However, it was not different by 7 months of age. Infants (Group A)immunized with HBIG and vaccine had a significantly higher geometric mean titer (GMT, milli-International Units/ml) of anti-HBs than those (Group B) with vaccines only at 2 months of age (P< 0.001). Conversely at 7 months of age, the GMT of anti-HBs was significantly higher in infantswho received vaccine only (P = 0.001). A protective level of antibodies was achieved earlier inthose infants receiving both passive and active immunizations. However, infants receiving activeimmunizations alone achieved a higher GMT at 7 months of age. There was no clear benefit ofpassive-active vs.active immunization alone for chronic HBV infection in infants of HBsAgpositive,HBeAg-negative mothers.Yao JL. Perinatal transmission of hepatitis B virus infection and vaccination in China. Gut 1996;38(Suppl 2):S37-S38.Department of Infectious Diseases, Sun Yat-Sen University of Medical Sciences, Guangzhou, PRChina.Hepatitis B remains one of the most important infectious diseases in China. In 1980, an overallhepatitis B virus (HBV) infection rate of 42.6% was reported and a hepatitis B surface antigen(HBsAg) carrier rate of 10.3%. HBsAg positivity among children under 1 year of age ranged from5.1% in Beijing to 7% in Guangdong. A peak in carrier rate was observed in 7 to 14 year olds,reaching 24% in Guangdong. During the past decade, there has been no significant change inoverall HBV carrier rates. However, in areas where hepatitis B vaccination for all neonates hasbeen introduced, a decline in HBsAg positivity in lower age groups has been observed. Perinataltransmission is believed to account for 35-50% of carriers although horizontal transmission is alsoimportant, particularly within families. Infants born to HBeAg positive carrier mothers are at evengreater risk of infection. HBV infection during childhood leads to an increased risk of seriouslongterm sequelae, including hepatocellular carcinoma (HCC). It is hoped that universal childhoodimmunisation will allow control of HBV infections in China within a few generations.Yao GB. Importance of perinatal versus horizontal transmission of hepatitis B virus infection inChina. Gut 1996; 38(Suppl 2):S39-S42.Jingan Clinical Immunology Research Centre, Jingan Qu Central Hospital, Shanghai, PR China.China has one of the highest rates of hepatitis B virus (HBV) endemicity in the world. In a surveyof five provinces, the overall HBV infection rate in the general population was found to be 42.6%,with 10.3% testing positive for hepatitis B surface antigen (HBsAg). Higher rates were found inrural than in urban areas. The prevalence of HBsAg among children under 1 year of age is quitelow but increases rapidly thereafter, reaching a peak among 5 to 9 year olds. The pattern of agedistribution suggests that horizontal transmission is an important route of HBV infection duringearly childhood, and the proportion of chronic HBsAg carriage attributable to perinatal46
transmission has been estimated at only 13-20%. Contact with infected family members probablyaccounts for much of the horizontal transmission in children. In a nationwide survey, 27.2% offamilies were found to have one or more HBsAg positive members and a strong tendency forfamily clustering has been identified. The strategy for prevention of HBV infection includesvaccination of all newborns, whether their mothers are HBsAg positive or negative, together withvaccination of high risk populations, and improved control measures in clinics and bloodtransfusion centres.Yu XL, Chen CH, Zhong M. Reasons of failure in blocking mother-infant transmission of HBVby using vaccine and related strategies. Zhonghua Hu Li Za Zhi 1997; 32:69-71. [Article inChinese]Nanfang Hospital, First Medical Colege of PLA, Guangzhou, PR China.We have detected the serum marker of HBV of 32 mothers whose HBsAg present positive andtheir children whom were given Hepatitis B vaccine immunization throughout duration of theirmothers' pregnancy, altogether making up 66 cases. In 3 of these 32 families, Hepatitis B vaccinefailed to block transmission between mother and infant. Direct nucleotide sequence analysis ofHBV were carried out in 7 HBsAg-positive infected persons. To confirm the possibility of HBVtransmission between mother and infant on molecular level, we used PCR technique and DNAsequencing method. The reasons of which HBV vaccine failed in blocking transmission werediscussed at the point of views of virus variation. Besides, we make and emphasized discussion onhow to tighten up the measurement of controlling the course of infection and protectingsusceptible population.Yue YF, Jiang H, Shi L, Li LF, Xi BS, Yu YL, Chen GF. Study on the mechanism ofintrauterine infection of hepatitis B virus. Zhonghua Fu Chan Ke Za Zhi 2004; 39:224-226.[Article in Chinese]Department of Obstetrics and Gynecology, First Hospital, Xi'an Jiaotong University, Xi'an710061, PR China.The aim was to study the possible mechanism of intrauterine infection of hepatitis B virus (HBV).HBV DNA was examined in amniotic fluid, and vaginal secretion of 59 HBsAg positive mothersand in cord blood of their neonates by PCR. Ten negative hepatitis B virus marker (HBVM)mothers and their neonates were served as control. HBsAg and HBcAg in placenta were examinedby avidin biotin complex (ABC) method. The detection rate of HBV DNA in amniotic fluid,vaginal secretion and neonatal cord blood of the study group were 47.5% (28/59), 52.5% (31/59)and 45.8% (27/59) respectively. HBsAg and HBcAg in placenta was distributed in the followingdescending order: maternal decidual cells, trophoblastic cells, villous mesenchymal cells andvillous capillary endothelial cells. But the distribution was in reverse order in 4 placentas. HBsAgand HBcAg were detected in amniotic epithelial cells in 32 mothers. The main route of HBVtransmission from mother to fetus is transplacental, from maternal side of placenta to fetal side.However, HBV intrauterine infection may take place through other routes.Yue Y, Yang X, Zhang S. Prevention of intrauterine infection by hepatitis B virus with hepatitisB immune globulin: efficacy and mechanism. Chin Med J (Engl) 1999; 112:37-39.Department of Obstetrics and Gynecology and Lab of Hepatitis, First Clinical College of Xi'anMedical University, Xi'an 710061, PR China.The objective was to evaluate the efficacy of hepatitis B immune globulin (HBIg) in preventing47
Page 1 and 2: Pre-meeting documentPrevention and
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Page 21 and 22: HBsAg and anti-HBs in 4.5%. In the
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Page 27 and 28: Delaying vaccination of premature i
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Page 31 and 32: shows that the prevalence of HBV in
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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: of hepatitis B vaccine. This study
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Page 55 and 56: Onishchenko GG. Incidence of infect
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