The risk of transmission of hepatitis B may be diminished by following certain measures proposed by the WHO. These include: vaccination of all infants within 24 hours of birth; vaccination of certain risk groups, such as travelers to endemic areas and healthcare workers (if these have not been vaccinated yet); avoidance of sexual contact with a person who has acute or chronic hepatitis B; and avoiding to share personal items, such as razors or toothbrushes. HBV vaccine is effective in preventing HBV infections when it is given either before exposure or shortly after exposure.
All infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours
The birth dose should be followed by 2 or 3 doses to complete the primary series. In most cases, 1 of the following 2 options is considered appropriate:
All children and adolescents younger than 18 years old and not previously vaccinated should receive the vaccine
People who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantations
People interned in prisons
Injecting drug users
Household and sexual contacts of people with chronic HBV infection
People with multiple sexual partners, as well as health-care workers and others who may be exposed to blood and blood products through their work
Travellers who have not completed their hepatitis B vaccination series should be offered the vaccine before leaving for endemic areas
Avoid sharing personal items, such as razors or toothbrushes.
Do not share drug needles or other drug equipment (such as straws for snorting drugs)
Clean blood spills with a solution containing 1 part household bleach to 10 parts water
Prevention of Infection
The hepatitis B vaccine is the mainstay of hepatitis B prevention. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by 2 or 3 doses to complete the primary series. In most cases, 1 of the following 2 options is considered appropriate:
A 3-dose schedule of hepatitis B vaccine, with the first dose (monovalent) being given at birth and the second and third (monovalent or combined vaccine) given at the same time as the first and third doses of DTP vaccine
4 doses, where a monovalent birth dose is followed by 3 monovalent or combined vaccine doses, usually given with other routine infant vaccines
The complete vaccine series induces protective antibody levels in more than 95% of infants, children and young adults. Protection lasts at least 20 years and is possibly lifelong.
All children and adolescents younger than 18 years old and not previously vaccinated should receive the vaccine if they live in countries where there is low or intermediate endemicity. In those settings it is possible that more people in high risk groups may acquire the infection and they should also be vaccinated. They include:
People who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantations
People interned in prisons
Injecting drug users
Household and sexual contacts of people with chronic HBV infection
People with multiple sexual partners, as well as health-care workers and others who may be exposed to blood and blood products through their work
Travellers who have not completed their hepatitis B vaccination series should be offered the vaccine before leaving for endemic areas
Mandatory reporting of the disease allows state health care workers to track people who have been exposed to the virus. The vaccine is given to those who have not yet developed the disease.
Avoid sharing personal items, such as razors or toothbrushes.
Do not share drug needles or other drug equipment (such as straws for snorting drugs)
Clean blood spills with a solution containing 1 part household bleach to 10 parts water
Hepatitis B (and hepatitis C) viruses cannot be spread by casual contact, such as holding hands, sharing eating utensils or drinking glasses, breast-feeding, kissing, hugging, coughing, or sneezing.
Importance of lifestyle modifications, such as reduction of alcohol consumption
Risk of transmission to others:
Household memebers with negative test results for HBV serologic markers should be vaccinated.
Regular sexual partners with negative test results for HBV serologic markers should be vaccinated.
Casual sexual partners or unvaccinated regular sexual partners should prefer barrier protection methods.
Pregnant HBsAg-positive women should inform their healthcare providers, so that Hepatitis B Immune Globulin and hepatitis B vaccine may be administered to the infant after delivery.
Healthcare workers infected with hepatitis B should consult an expert review panel.
In case of organ transplant, in which anti-HBc-positive organ donors are used for HBV seronegative recipients, HBV infection should be prevented with the administration of antiviral therapy. 6-12 months of prophylactic therapy may be sufficient for organ transplants, other than hepatic. For hepatic transplants, it is recommended life-long antiviral therapy.
The primary hepatitis B immunization series conventionally consists of three doses of vaccine. Vaccination of infants and, in particular, delivery of hepatitis B vaccine within 24 hours of birth is 90–95% effective in preventing infection with HBV as well as decreasing HBV transmission if followed by at least two other doses. WHO recommends universal hepatitis B vaccination for all infants, and that the first dose should be given as soon as possible after birth.[1][6]This strategy has resulted in a dramatic decrease in the prevalence of CHB among young children in regions of the world where universal infant vaccination programs have been implemented. A proportion of vaccinated children (5–10%) have a poor response to vaccination, and will remain susceptible as adults to acquisition of HBV infection.[1][7]
WHO recommends that hepatitis B vaccine be included in routine immunization services in all countries. The primary objective of hepatitis B immunization is to prevent chronic HBV infections which result in chronic liver disease later in life. By preventing chronic HBV infections, the major reservoir for transmission of new infections is also reduced.The natural reservoir for hepatitis B virus is man. Closely related hepadnaviruses have been found in woodchucks and ducks, but they are not infectious for humans.[1]
↑Morbidity and Mortality Weekly Report. A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States. http://www.cdc.gov/mmwr/PDF/rr/rr5516.pdf Accessed on October 4th, 2016
↑Ni JD, Xiong YZ, Wang XJ, Xiu LC. Does increased hepatitis B vaccination dose lead to a better immune response in HIV- infected patients than standard dose vaccination: a meta-analysis? Int J STD AIDS. 2013;24(2):117–22.
↑Liu CJ, Liou JM, Chen DS, Chen P J.Natural course and treatment of dual hepatitis B virus and hepatitis C virus infections. J Formos Med Assoc Taiwan. 2005;104(11):783–91.