Passive and Active Immunization in Prevention of Vertical Transmission of HBV Infection in Infants of HBsAg Positive Mothers

Abstract

Introduction and Aims: In order to prevent liver cirrhosis and hepatocellular carcinoma in later life, it is essential to prevent Hepatitis B virus (HBV) infection in infants. Despite the availability of an effective vaccine, hepatitis B still continues to be a significant health problem. The aim of this study is to reveal the efficacy of passive and active immunoprophylaxis for preventing perinatal transmission of the hepatitis B virus in Iran.

Materials and Methods: In this cohort study with historical controls, 823 children of the HBsAg positive mothers were evaluated. There were 637 cases who had received neither Hepatitis B (HB) vaccine nor hepatitis B immunoglobulin (HBIG), 125 persons received only HB vaccine and 60 neonates that we administered them HB vaccine and HBIG together.

Results: The prevalence of HBsAg in cases who have received neither vaccine nor HBIG and aged › 16 years (group1) or ≤ 16 years (group 2), cases who have received vaccine alone (group 3), and in cases who have received both vaccine and HBIG (group 4) was 56.1%, 40.3%, 12.6%, and 3.6%, respectively. The prevalence of HBsAb had a significant descending rate in groups 4 (85.7%), 3 (68.8%), 2 (33.3%), and 1 (21.8%) respectively.

Conclusions: The addition of HBIG to recombinant vaccine will significantly increase the protection against HBV infection in comparison with HB vaccine without HBIG. After focusing on the vertical route for many years, and implementing strategies such as vaccination and HBIG injection to neonates of HBsAg positive mothers, nowadays it seems that we should pay more attention to horizontal way of HBV transmission in Iran.