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[Combined passive and active immunization for preventing the development of the infantile carrier state in hepatitis
Insights
Hepatitis B (HB) immunoglobulin (HBIG) and vaccine effectively prevent infant carrier status from mothers with HB e antigen-positive HB surface antigen. Early vaccination and timely HBIG re-administration significantly reduce vertical transmission rates.
Area of Science:
- Immunology
- Hepatology
- Virology
Context:
- Hepatitis B virus (HBV) vertical transmission poses a significant risk for infants born to carrier mothers.
- Infantile HBV carrier state is associated with long-term health complications, including cirrhosis and hepatocellular carcinoma.
- Current prevention strategies involve passive and active immunization, but optimal timing and schedules require further evaluation.
Purpose:
- To evaluate the clinical usefulness of combined passive (HBIG) and active (HB vaccine) immunization in preventing infantile hepatitis B (HB) carrier state.
- To assess the impact of HBIG re-administration intervals and vaccination timing on preventing HBV vertical transmission.
- To compare the efficacy of the combined immunization strategy against a control group of untreated infants.
Summary:
- A study of 43 infants born to HBeAg-positive HBsAg carrier mothers showed a significantly lower carrier rate (11.6%) compared to 78 untreated infants (73.1%).
- Infants receiving HBIG every 3 months had a lower carrier rate (3.6%) than those receiving it every 4 months (26.7%).
- Early vaccination initiation (2-4 months) resulted in a higher persistent HBsAb-positive rate (93.3%) compared to delayed vaccination (12 months, 76.9%). No adverse effects were observed.
Impact:
- The combined passive and active immunization strategy is safe, economical, and effective in preventing infantile HBV carrier state.
- Early initiation of vaccination and timely HBIG re-administration are crucial for preventing HBV vertical transmission.
- This approach offers a viable solution to reduce the global burden of chronic Hepatitis B infection.
Abstract:
By applying hepatitis B (HB) immunoglobulin (HBIG) and HB vaccine (vaccine) to 43 infants born to HB e antigen (HBeAg)-positive HB surface antigen (HBsAg) carrier women intramuscularly, and sub-and/or intra-cutaneously, respectively, the clinical usefulness of combined passive and active immunization in preventing infantile development of the carrier state was evaluated. The results obtained in this study are summarised as follows: Of the 43 infants, 5 (11.6%) developed the carrier state and 38(88.4%) were persistent HBsAb-positive. This carrier-rate was found to be significantly lower than that of 78 non-treated infants (73.1%) born to HBeAg-positive carrier women (control). Four of 15 infants (26.7%), who received HBIG every 4 months, developed carrier state, while only one case (3.6%) fell into carrier state in 28 infants who received HBIG every 3 months. In 30 infants whose vaccination was started at 2 or 4 months of age, 93.3% of the cases became persistent HBsAb-positive within 12 months, while 76.9% of 13 infants who underwent the first vaccination at 12 months of age became persistent HBsAb-positive. No adverse effects of HBIG and HB vaccine were observed in this study. In addition, the mean values for serum glutamic pyruvic transaminase (SGPT) were 35 and 69mu/ml in the treated and control groups, respectively. Thus, the present study demonstrates that the infantile development of HBsAg carrier state by HB virus-vertical transmission could be safely, economically and easily prevented by early initiation of vaccination and re-administration of HBIG within 3 months.