Hepatitis B Immunoglobulin, Vaccine Series Prevents Mother-to-Child Transmission

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Prompt post-exposure prophylaxis offers newborns protection from perinatal infection from hepatitis B surface antigen-positive mothers.
Prompt post-exposure prophylaxis offers newborns protection from perinatal infection from hepatitis B surface antigen-positive mothers.

A combined birth dose of hepatitis B immunoglobulin 100 IU with hepatitis B vaccine series resulted in a low rate of perinatal infection of infants born to hepatitis B surface antigen (HBsAg)-positive mothers, according to the results of research published in Vaccine.

In this Chinese prospective study, mother-infant pairs with positive maternal HBsAg were enrolled. Infants received hepatitis B immunoglobulin 100 IU or 200 IU within 12 hours of birth, followed by the complete hepatitis B vaccine series. Infants underwent postvaccination serologic testing at 7 months (100 IU: n=545; 200 IU: n=632) and up to 12 months (100 IU: n = 451; 200 IU: n = 529).

At 7 months, the rates of perinatal infection were not significantly different between the 100-IU and 200-IU hepatitis B immunoglobulin groups (1.5% vs 1.9%; P =.57). A nonresponder infant in the 200-IU group became newly infected at 12 months.

The proportion of infants who were positive for antibody to HBsAg was similar between the 100-IU and 200-IU groups at 7 months (98.5% vs 98.2%; P =.70) and 12 months (98.2% vs 97.1%; P =.27). Similarly, geometric mean concentrations of anti-HBsAg were not significantly different between 100-IU and 200-IU groups at 7 months (707.95 mIU/mL vs 602.56 mIU/mL; P =.06) and 12 months (245.47 mIU/mL vs 229.09 mIU/mL; P =.41).

Among infants born to HBsAg-negative mothers, the rate of those who were anti-HBsAg-positive and geometric mean concentration were similar between 100-IU and 200-IU groups. The production of anti-HBsAg, however, was lower in the 200-IU group at 7 months (741.31 mIU/mL vs. 602.56 mIU/mL; P =.03).

The study authors concluded that "timely passive-active immunoprophylaxis significantly reduces the occurrence of [mother-to-child transmission of hepatitis B virus]. Similar to what has been reported in the United States, in this prospective cohort study, with a relatively large number of participants, timely post-exposure prophylaxis protected up to 98.3% of infants born to HBsAg-positive mothers from being perinatally infected."

Reference

Wei KP, Zhu FC, Liu JX, et al. The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus: a prospective cohort study [published online November 28, 2017]. Vaccine. 2017. doi: 10.1016/j.vaccine.2017.11.037

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