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Passive--active immunization in a neonate treated with repeated doses of high-titred hepatitis B immune globulin
Insights
High-dose hepatitis B immune globulin (HBIg) prophylaxis was given to an infant born to a hepatitis B surface antigen (HBsAg)-positive mother. The infant experienced a subclinical hepatitis B infection, which appeared to cause no harm.
Area of Science:
- Hepatology
- Immunology
- Neonatal Care
Background:
- Hepatitis B virus (HBV) infection poses a significant risk to newborns born to infected mothers.
- Hepatitis B immune globulin (HBIg) is used for post-exposure prophylaxis.
- Maternal HBsAg positivity with HBeAg and DNA-polymerase activity indicates high infectivity.
Purpose of the Study:
- To evaluate the efficacy of high-dose HBIg prophylaxis in a newborn exposed to HBV.
- To assess the clinical and immunological outcomes in an infant receiving HBIg for HBV exposure.
Main Methods:
- Administration of repeated, very high doses of HBIg to a newborn.
- Monitoring of maternal hepatitis B serological markers (HBsAg, HBeAg).
- Serial assessment of infant's liver function tests and hepatitis B serological markers (anti-HBc, anti-HBs).
Main Results:
- Maternal HBsAg negativity achieved approximately 8 months postpartum.
- Discontinuation of HBIg prophylaxis based on maternal status.
- Infant exhibited normal liver function tests at follow-up.
- Significantly increased antibodies against HBcAg and HBsAg detected in the infant, indicating a subclinical HBV infection.
Conclusions:
- High-dose HBIg prophylaxis may be effective in preventing overt hepatitis B in high-risk newborns.
- Subclinical hepatitis B infection can occur despite prophylaxis.
- The subclinical infection in this case appeared to be without adverse consequences for the infant.
Abstract:
A newborn infant, born to a HBsAg-positive drug addict with HBeAg and DNA-polymerase activity in serum, was treated with repeated very high doses of hepatitis B immune globulin (HBIg). The mother turned HBsAg-negative about 8 months after deliver and the HBIg prophylaxis was then discontinued. A check-up of the infant about a year later revealed normal liver function tests but significantly increased levels of antibodies against HBcAg and HBsAg indicating a post subclinical hepatitis B infection, apparently without harm to the infant.