Revaccination of non-responding infants delivered by HBsAg-positive mothers

Excerpt

One of the most important routes of hepatitis B virus transmission is that from asymptomatic carrier mothers to their infants. Seventy to 90% of infants delivered by HBs- and HBeAg-positive and 5–20% of infants delivered by HBsAg- and HBe antibody-positive mothers will become infected at birth if immunoprophylaxis is not given [1, 2]. Infants of HBsAg-positive women who are not infected at birth are at increased risk of acquiring HBV infection during early childhood due to household contact with infected persons [1]. Hepatitis B infection at birth or during early childhood can result in chronic infection with a subsequent high risk of fatal liver disease. The preventive protocol for at-risk newborns includes the administration of 0.5 ml of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine within 12 h of birth, followed by two doses of vaccine at 1 and 6 months of age. Post-vaccination tests to detect HBsAg and antibodies against HBs are also recommended to determine the child’s infection status [1]. Since several studies have revealed that the primary course of vaccination does not result in protective levels of HBs antibodies in up to 22% of the children receiving it [3, 4], we decided to evaluate the efficacy of revaccination with two additional doses of HBV vaccine in non-responding children. …