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Hepatitis B mother--to--child transmission
Sylvie Ranger-Rogez1, François Denis
1Laboratoire de Virologie, CHU Dupuytren, 2 Avenue Martin Luther King, 87042 LIMOGES Cédex, France. sylvie.rogez@unilim.fr.
Expert Review of Anti-Infective Therapy
|October 16, 2004
Summary
Hepatitis B virus vaccination at birth significantly reduces new infections in endemic areas. Combining vaccination with lamivudine further lowers the risk of perinatal transmission from mother to infant.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Chronic hepatitis B virus (HBV) infection affects approximately 350 million people globally, posing a significant public health challenge.
- High endemicity areas (8-15% chronic infection) present a substantial risk of perinatal HBV transmission from infected mothers to newborns.
- The World Health Organization (WHO) recommends universal infant HBV vaccination at birth in highly endemic regions, irrespective of maternal HBV status.
Purpose of the Study:
- To evaluate the effectiveness of current hepatitis B vaccination strategies in reducing HBV infections.
- To assess the impact of combining neonatal immunization with antiviral therapy (lamivudine) on perinatal transmission.
- To outline recommended screening and vaccination protocols for different endemicity levels of HBV.
Main Methods:
- Review of existing vaccination programs and their impact on HBV infection rates.
- Analysis of studies investigating the efficacy of lamivudine in conjunction with neonatal hepatitis B vaccination.
- Examination of WHO recommendations for HBV screening and vaccination based on geographical endemicity.
Main Results:
- Systematic hepatitis B vaccination at birth has led to a marked decrease in acute HBV infections and related complications.
- The addition of lamivudine to neonatal immunization has been shown to dramatically reduce the residual risk of perinatal HBV transmission.
- In intermediate and low endemicity areas, maternal screening for hepatitis B surface antigen allows for targeted neonatal vaccination within 12 hours of birth, conferring long-term immunity.
Conclusions:
- Universal hepatitis B vaccination at birth is a cornerstone in controlling HBV infection, especially in highly endemic regions.
- Antiviral therapy, such as lamivudine, complements vaccination by significantly reducing mother-to-child transmission.
- Tailored screening and vaccination strategies are crucial for managing hepatitis B virus across diverse epidemiological settings.