Hepatitis B primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2], Sara Mehrsefat, M.D. [3]
Overview
The risk of transmission of hepatitis B may be reduced by the implementation of certain measures proposed by the WHO. These include the vaccination of all infants within 24 hours of birth; vaccination of members of certain risk groups, including travelers to endemic areas and healthcare workers (if they have not been vaccinated yet); avoidance of sexual contact with a person who has acute or chronic hepatitis B; and avoiding sharing personal items such as razors or toothbrushes. The HBV vaccine is effective in preventing HBV infections when it is administered either before exposure or shortly after exposure.[1][2][3]
Primary Prevention
According to the WHO, the following measures should be implemented to prevent infection by hepatitis B virus:[1][2][3]
Primary Prevention | Recommendations |
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Hepatitis B vaccine |
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Screening of all donated blood |
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Hepatitis B immune globulin |
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Lifestyle measures |
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Patients with chronic hepatitis B should be aware of the following:[1][2]
Education and Prevention of Hepatitis B |
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Vaccination
Hepatitis B vaccine is the most effective tool in preventing the transmission of HBV and HDV. Vaccines are composed of the surface antigen of HBV (HBsAg), and are produced by two different methods: plasma-derived and recombinant DNA. 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]
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 specifies that the first dose should be given as soon as possible after birth.[1][4] 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 small proportion of vaccinated children (5–10%) have a poor response to vaccination and remain susceptible to acquisition of HBV infection throughout their lives.[1][5]
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.
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 World Health Organization, Guidelines for the Prevention, Care, and Treatment of persons with chronic Hepatitis B Infection. (March 2015). http://apps.who.int/iris/bitstream/10665/154590/1/9789241549059_eng.pdf Accessed on October 4th, 2016
- ↑ 2.0 2.1 2.2 Morbidity and Mortality Weekly Report. A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States. (2006). http://www.cdc.gov/mmwr/PDF/rr/rr5516.pdf Accessed on October 4th, 2016
- ↑ 3.0 3.1 Centers for Disease Control and Prevention. Prevention and Control of Infections with Hepatitis Viruses in Correctional Settings http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5201a1.htm 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.