Prevention of Perinatally Transmitted Hepatitis B Virus Infections with Hepatitis B Immune Globulin and Hepatitis B Vaccine

Beasley, R. Palmer; Lee, George Chin Yun; Roan, Cheng Hsiung; Hwang, Lu Yu; Lan, Chung Chi; Huang, Fu Yuan; Chen, Chiung Lin

doi:10.1097/00006254-198406000-00007

Cited by 85 publications

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“…[5][6][7][8][9][10] It has been reported that HB vaccine given soon after birth is able to protect infants from perinatal infection, and HB infection became the first disease model to show that mother-to-neonate transmission can be interrupted by an effective vaccine. 11 Taiwan started a national program of HB vaccination since 1984. This program resulted in a significant reduction of the HB carrier rate in children under 10 years from 9.8% before nationwide vaccination to 1.3% after the program.…”

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confidence: 99%

“…[5][6][7] The proportion of vaccinees with protective antiHBs levels decreases to 75% to 87% 5 years after vaccination and further drops to 50% to 70% 10 to 12 years after. 10,11,[14][15][16][17][18][19][20][21] Because of the progressive decline of anti-HBs and the associated increased likelihood of development of new HBV infections, some investigators advise the use of a booster vaccination. 20,21 However, a preponderance of data indicates that the protective efficacy of the HB vaccine can last for at least 5 to 10 years, and a booster before 5 years is not necessary.…”

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Long–Term Response to Hepatitis B Vaccination and Response to Booster in Children Born to Mothers With Hepatitis B E Antigen

et al. 1999

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Hepatitis B (HB) vaccine provides an uncertain duration of protection and the optimal timing of booster vaccine remains unclear. This study examined the immune response at 10 years of 118 children who had developed protective anti-HB surface (anti-HBs) levels after a primary series of HB immunizations in infancy. All of the children were born to hepatitis B e Antigen (HBeAg)-positive hepatitis B surface antigen (HBsAg) carrier mothers. HB markers in all subjects and cellular immune response in some were determined. A booster was given to all subjects after the collection of samples and another blood sample was collected 4 weeks later. The results showed that a total of 39 (33%) of the children were seronegative for anti-HBs. T-cell proliferative response to HBsAg was noted in 47% of children. On HBsAg stimulation, leukocyte samples from a significantly higher proportion of subjects produced cytokines (81% of T cells produced interleukin-2 [IL-2] and 100% produced IL-5). The booster dose of HB vaccine induced the production of a protective level of anti-HBs (H10 mIU/mL) in all subjects. Cellular immunity was augmented with a positive rate of 58%, 90%, and 100% for HBsAg-induced T-cell proliferation, IL-2 production, and IL-5 production, respectively. Although 14 (11.9%) of the subjects were HB core antibody positive at 10 years of age, no new HBsAg carrier was detected. The results of this study show that protection afforded by HB vaccination persisted to the age of 10 years in all vaccinees. Immunologic memory was detected in all subjects including those who had lost their anti-HBs seropositivity. These results suggest that no booster vaccination is needed before 10 years of age. The most sensitive marker of immunologic memory is IL-5 production of T cells. (HEPATOLOGY 1999;29: 954-959.)Taiwan is an endemic region for hepatitis B (HB). Before the implementation of a nationwide vaccination program in 1984, the hepatitis B virus (HBV) carrier rate in the general population was 15% to 20%. 1-2 The major impact of HB infection is its long-term sequelae, which may include chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. 3 Perinatal infection accounts for 40% to 50% of all HB infections and is responsible for the generation-to-generation transmission of HBV. 4 HB vaccines, both plasma derived and recombinant, are highly immunogenic and efficacious. 5-10 It has been reported that HB vaccine given soon after birth is able to protect infants from perinatal infection, and HB infection became the first disease model to show that mother-to-neonate transmission can be interrupted by an effective vaccine. 11 Taiwan started a national program of HB vaccination since 1984. This program resulted in a significant reduction of the HB carrier rate in children under 10 years from 9.8% before nationwide vaccination to 1.3% after the program. 12 It also decreased the incidence of hepatocellular carcinoma in children aged 6 to 9 years from 0.52 to 0.13 per 100,000. 13 However, the duration of protection provided by the...

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Long–Term Response to Hepatitis B Vaccination and Response to Booster in Children Born to Mothers With Hepatitis B E Antigen

et al. 1999

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“…Active immunization with three or four doses of HBV vaccine without HBIG was proved to be immunogenic in more than 90% of infants of noncarrier mothers or HBeAg-negative carrier mothers. In infants of highly infectious (HBeAg seropositive HBsAg carrier) mothers, the prevention efficacy of using HBV vaccines was only 75% (Table 2) (Beasley et al 1983c). …”

Section: Active Immunization By Hbv Vaccinementioning

confidence: 99%

Prevention of Hepatitis B

Chang

Chen

2015

Cold Spring Harbor Perspectives in Medicine

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Hepatitis B virus (HBV) causes life-threatening liver disease. It is transmitted through a horizontal route or a mother-to-infant route, and the latter is the major route in endemic areas. Prevention of HBV infection by immunization is the best way to eliminate HBV-related diseases. The HBV vaccine is the first human vaccine using a viral antigen from infected persons, which is safe and effective. Either passive immunization by hepatitis B immunoglobulin (HBIG) or active immunization by HBV vaccine is effective, and a combination of both yields the best efficacy in preventing HBV infection. The impact of universal HBV immunization is huge, with 90%-95% effectiveness in preventing chronic HBV infection. It is the first cancer preventive vaccine with a protective efficacy against hepatocellular carcinoma (HCC) of 70%. Nevertheless, further effort is still needed to avoid vaccine failure and to increase the global coverage rate.

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“…When effective vaccines against HBV became available in adults, 38,39 investigators immediately thought of immunizing newborns, because mother-to-infant transmission of HBV was known to result in chronic infection. [20][21][22]40 Beasley et al 41 and Lo et al 42 performed such studies in infants, showing that passive and active immunization were effective in interrupting perinatal HBV transmission.…”

Section: The Universal Hepatitis B Mass Vaccination Program In Infantsmentioning

confidence: 99%

Fighting against viral hepatitis: Lessons from Taiwan

Chen

2011

Hepatology

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Viral hepatitis and its sequelae are important health problems worldwide, including Taiwan. For the last 40 years, Taiwan's scientists and health care providers have worked hard to control these sequelae, and the results have been excellent. The author, Ding-Shinn Chen, had a key role in planning and establishing the control program in Taiwan, and participated in the endeavors from the very beginning. In this perspective, he describes how he became interested in research as a medical student, his encounters with hepatitis B and C, how he and his colleagues started early detection of hepatocellular carcinoma (HCC), how he helped Taiwan's government create and implement the Viral Hepatitis Control Program, and how the effectiveness of the program in the decrease of hepatitis B carriage and HCC was monitored. He also discusses how he pioneered the use of interferon-α plus ribavirin to treat chronic hepatitis C. Hepatitis B viral load as a risk factor for HCC and cirrhosis in hepatitis B surface antigen carriers is reviewed briefly, as is the prevention of sequelae by antiviral therapies. Finally, Dr. Chen discusses unresolved issues that must be addressed and predicts the changes of the patterns of liver disease in Taiwan beyond the mid-21st century, which is in part affected by the fight against viral hepatitis that was initiated in the early 1980s. Conclusion : Dr. Chen's perspective illustrates Taiwan's fight against viral hepatitis over the last 40 years. This experience can be shared by other countries in which the disease is equally prevalent. (Hepatology 2011;)

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Prevention of Perinatally Transmitted Hepatitis B Virus Infections with Hepatitis B Immune Globulin and Hepatitis B Vaccine

Cited by 85 publications

References 0 publications

Long–Term Response to Hepatitis B Vaccination and Response to Booster in Children Born to Mothers With Hepatitis B E Antigen

Long–Term Response to Hepatitis B Vaccination and Response to Booster in Children Born to Mothers With Hepatitis B E Antigen

Prevention of Hepatitis B

Fighting against viral hepatitis: Lessons from Taiwan

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