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Long term efficacy of hepatitis B immunoprophylaxis in neonates at risk: using different vaccine and schedule

A Assateerawatt1, V Suvatte, V S Tanphaichitr

  • 1Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Insights

Different hepatitis B immunization strategies showed similar long-term effectiveness in preventing hepatitis B virus (HBV) transmission in newborns. All tested hepatitis B immunoglobulin (HBIG) and vaccine combinations provided significant protection up to three years of age.

Area of Science:

  • Immunology
  • Virology
  • Pediatrics

Background:

  • Hepatitis B virus (HBV) transmission from HBeAg-positive mothers to neonates poses a significant public health challenge.
  • Effective immunoprophylaxis is crucial to prevent perinatal HBV infection.

Purpose of the Study:

  • To evaluate the long-term efficacy of various combined hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine regimens.
  • To compare different doses and schedules of HBIG and vaccine for preventing HBV transmission in high-risk neonates.

Main Methods:

  • Eight groups of 20 neonates each were administered different combinations and dosages of HBIG (100 IU or 200 IU, IM or IV) and hepatitis B vaccine (full or half dose).
  • Vaccination schedules included 0, 1, 2 months or 0, 1, 6 months, with some receiving a booster at 12 months.
  • Infants were followed up to 3 years of age to assess seroconversion rates, protective efficacy, and antibody responses (anti-HBs titer).

Main Results:

  • No statistically significant differences were observed among the eight immunoprophylaxis programs in terms of seroconversion rates, protective efficacy, or anti-HBs antibody titers after 3 years.
  • Seroconversion rates ranged from 63.6% to 92.9% across all groups.
  • Protective efficacy rates varied from 69.7% to 100% by 3 years of age.

Conclusions:

  • Various HBIG and hepatitis B vaccine combinations and schedules demonstrate comparable long-term efficacy in preventing HBV transmission in neonates born to HBeAg-positive mothers.
  • The findings suggest flexibility in choosing immunoprophylaxis strategies without compromising protection against HBV infection.

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