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

at birth and 2 weeks after birth, followed by 30 micro g plasma-derived HB vaccine or 5 µgrecombinant yeast-derived hepatitis B vaccine at 1, 2 and 7 months of age. Blood tests wereperformed for all the lying-in women and their neonates. Blood specimens were tested for HBsAgand HBeAg by enzyme immunoassay. All infants were followed up for 1 year. In the HBIg group,491 neonates were born to 487 HBV carrier mothers; and in the control group, 496 neonates wereborn to 493 HBV carrier mothers. The rates of intrauterine transmission in the two groups were14.3% and 5.7% respectively (chi 2 = 20.280, P < 0.001), and the rates of chronic hepatitis B in thetwo groups were 2.2% and 7.3% respectively (chi 2 = 13.696, P < 0.001). The high risk factors ofintrauterine HBV infection included HBsAg HBeAg double positive and HBV DNA positive inthe peripheral blood of pregnant women. HBV infection in the uterus may be interrupted byinjecting multiple intramuscular HBIg injections before delivery without causing any side-effects.Zimmerman RK, Ruben FL, Ahwesh ER. Hepatitis B virus infection, hepatitis B vaccine, andhepatitis B immune globulin. J Fam Pract 1997; 45:295-315.Hepatitis B virus (HBV) infection is a major health problem in the United States; in 1995,approximately 128,000 cases occurred. Transmission of HBV occurs primarily by blood exchange(e.g., by shared needles during injection drug use) and by sexual contact. Persons infected early inlife are much more likely to become chronically infected than those infected during adulthood: asmany as 90% of infants infected perinatally develop chronic infection and up to 25% will die ofHBV-related chronic liver disease as adults. Clinical signs of acute hepatitis occur in about 50% ofinfected adults but in only 5% of infected preschool-aged children. In the United States, hepatitis Bvaccine is currently made by recombinant DNA technology using baker's yeast. Preexposurevaccination results in protective antibody levels in almost all infants and children (> 95%) andhealthy adults younger than 40 years of age (> 90%). The most common adverse event followingadministration of hepatitis B vaccine is pain at the injection site, which occurs in 13% to 29% ofadult and 3% to 9% of children. A comprehensive hepatitis B vaccination policy is nowrecommended that includes (1) routine infant vaccination; (2) catch-up vaccination of 11- to 12-year-olds who were not previously vaccinated; (3) catch-up vaccination of young children at highrisk for infection; (4) vaccination of adolescents and adults based on lifestyle or environmental,medical, and occupational situations that place them at risk; and (5) prevention of perinatal HBVinfection.49