Perinatal Hepatitis B Virus Transmission in the United States
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
- 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).
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)
Footnotes
-
Reprint requests to The New York Blood Center, 310 E 67th St, New York, NY 10021 (Dr Stevens).
