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Prevention by Passive-Active Immunization

Cladd E. Stevens, MD; Pearl T. Toy, MD; Myron J. Tong, MD; Patricia E. Taylor, PhD; Girish N. Vyas, PhD; Prem V. Nair, MD; Madhu Gudavalli, MD; Saul Krugman, MD

JAMA. 1985;253(12):1740-1745.

Abstract
Among infants born to women in whom sera are positive for both the hepatitis B surface antigen and the e antigen, 85% to 90% are infected with hepatitis B virus and become chronic hepatitis B surface antigen carriers. In a study to assess the effectiveness of passive-active prophylaxis (hepatitis B immune globulin and hepatitis B vaccine) of such infants, we screened 18,842 pregnant Asian-American women: 8.7% were positive for hepatitis B surface antigen and 3.0% were also positive for hepatitis B e antigen. Thus far, 113 infants have received hepatitis B immune globulin (0.5 mL at birth) and hepatitis B vaccine (three 20-µg doses beginning at birth or at 1 month) and have been followed up for nine to 18 months. Among these infants, 16 have become chronic carriers, an incidence of only 14.2%. All of the uninfected infants have retained high levels of antibody to surface antigen, suggesting that they have had an active immune response to the vaccine and should have long-term protection against hepatitis B virus.

(JAMA 1985;253:1740-1745)

Author Affiliations
From the Wolf Szmuness Laboratory of Epidemiology, Lindsley F. Kimball Research Institute of The New York Blood Center, New York (Drs Stevens and Taylor); the Department of Laboratory Medicine, University of California, San Francisco (Drs Toy and Vyas); the Liver Center, Huntington Memorial Hospital, Pasadena, Calif (Drs Tong and Nair); and the Department of Pediatrics, New York University College of Medicine, New York (Drs Gudavalli and Krugman).

Footnotes
Reprint requests to The New York Blood Center, 310 E 67th St, New York, NY 10021 (Dr Stevens).

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