Public Health

Vaccinating newborn infants of mothers with hepatitis B prevents transmission

Last Updated: 2006-01-26 19:01:19 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Treating newborn infants of mothers positive for hepatitis B surface antigen with either hepatitis B vaccine or hepatitis B immunoglobulin protects the babies from the infection, results of a systematic review and meta-analysis of randomized clinical trials suggest. The combination of vaccination and immunoglobulin is associated with even better protection.

Mother-to-child transmission accounts for up to 50% of hepatitis B carriers, Dr. Yan Gong, from Copenhagen University Hospital in Denmark, and colleagues note in their report in BMJ Online First, published on January 26.

Dr. Gong's group conducted a literature search that identified 26 trials of newborn infants of mothers positive for hepatitis B surface antigen who were randomized to hepatitis B vaccination or hepatitis B immunoglobulin or both within the first month of life. Duration of follow-up averaged 19 months.

According to the team's report, four trials showed that hepatitis B vaccination significantly decreased the risk of hepatitis B occurrence compared with placebo or no intervention (relative risk 0.28).

The studies showed that recombinant vaccine and plasma-derived vaccine were not significantly different in efficacy. However, significantly fewer infants receiving recombinant vaccine had antibody levels to hepatitis B surface antigen < 10 IU/L (RR 0.51).

Hepatitis B immunoglobulin also significantly decreased the risk of hepatitis B occurrence in infants (RR 0.52). Compared with vaccination alone, vaccination plus hepatitis B immunoglobulin significantly reduced disease occurrence (RR = 0.54).

Compared with placebo or no intervention, plasma derived vaccine plus hepatitis B immunoglobulin reduced the relative risk to 0.08.

"In general, we were unable to show significant differences among different doses, different schedules, and different forms of plasma derived vaccine and recombinant vaccine on hepatitis B occurrence," Dr. Gong's group notes. Timing of injections at 12, 24, or 48 hours also appeared to have no effect on outcome.

BMJ Online First 2006.