Hepatitis B secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Hepatitis B Immunoglobulin (HBIG) is a form of passive [[immunization]] when given shortly before | Hepatitis B Immunoglobulin (HBIG) is a form of passive [[immunization]] when given shortly before or soon after exposure to [[hepatitis B virus]]. It is also administered in combination with HBV [[vaccines]] to the newborns of [[HBsAg]] positive mothers.<ref name=WHO-Guideline-Hepatitis-B> 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</ref><ref name=MMWR-Hepatitis> 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</ref> | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
===Hepatitis B Immunoglobulin=== | ===Hepatitis B Immunoglobulin=== | ||
HBIG provides passively acquired anti-HBs and temporary protection (3-6 months) when administered in standard doses. HBIG is typically used as an adjunct to [[hepatitis B vaccine]] for postexposure immunoprophylaxis to prevent HBV infection. HBIG administered alone is the primary means of protection after an HBV exposure for nonresponders to [[Hepatitis B vaccine|hepatitis B vaccination]].<ref name=WHO-Guideline-Hepatitis-B> 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</ref><ref name=MMWR-Hepatitis> 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</ref> | HBIG provides passively acquired anti-HBs and temporary protection (3-6 months) when administered in standard doses. HBIG is typically used as an adjunct to [[hepatitis B vaccine]] for postexposure [[immunoprophylaxis]] to prevent HBV infection. HBIG administered alone is the primary means of protection after an HBV exposure for nonresponders to [[Hepatitis B vaccine|hepatitis B vaccination]].<ref name=WHO-Guideline-Hepatitis-B> 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</ref><ref name=MMWR-Hepatitis> 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</ref> | ||
HBIG is similar to conventional IG preparations except that it is prepared from [[plasma]] preselected for a high titre of anti-HBs (>100 000 IU/ml of anti-HBs). The [[plasma]] is screened to eliminate donors who are positive for [[HBsAg]], antibodies to [[HIV]] and [[hepatitis C virus]] (HCV), and HCV [[RNA]]:<ref name= | HBIG is similar to conventional IG preparations except that it is prepared from [[plasma]] preselected for a high titre of anti-HBs (>100 000 IU/ml of anti-HBs). The [[plasma]] is screened to eliminate donors who are positive for [[HBsAg]], antibodies to [[HIV]] and [[hepatitis C virus]] (HCV), and HCV [[RNA]]:<ref name=WHO-Guideline-Hepatitis-B> 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</ref> | ||
* HBIG protects by passive [[immunization]] if given shortly before or soon after exposure to [[HBV]]. | * HBIG protects by passive [[immunization]] if given shortly before or soon after exposure to [[HBV]]. | ||
* The protection is immediate, but it lasts only 3 to 6 months. | * The protection is immediate, but it lasts only 3 to 6 months. | ||
* HBIG is not recommended as pre-exposure [[prophylaxis]] because of high cost, limited availability, and short-term effectiveness. HBIG is generally not affordable in developing countries. | * HBIG is not recommended as pre-exposure [[prophylaxis]] because of high cost, limited availability, and short-term effectiveness. HBIG is generally not affordable in developing countries. | ||
* HBIG should be given to adults within 48 hours of [[HBV]] exposure. | |||
* HBIG should be given to adults within 48 | * Maternal-neonatal [[transmission]] of HBV and the subsequent development of chronic hepatitis B in infected children is reduced drastically when HBIG is given to the newborn babies of HBV carrier mothers in conjunction with the first dose of the HB vaccine. | ||
* Maternal-neonatal [[transmission]] of HBV and the subsequent development of chronic hepatitis B in infected children | |||
[[File:Prophylaxis Algorythm.png|thumb|center|800px|Postexposure prophylaxis algorythm <SMALL> Adapted from ''[http://www.who.int/en/ World Health Organization]''<ref>{{Cite web | title = | [[File:Prophylaxis Algorythm.png|thumb|center|800px|Postexposure prophylaxis algorythm <SMALL> Adapted from ''[http://www.who.int/en/ World Health Organization]''<ref>{{Cite web | title = WHO | url = http://www.who.int/en/}}</ref></SMALL>]] | ||
==Summary of Recommendations for Counseling and Prevention of Transmission of Hepatitis B from Individuals with Chronic HBV Infection: AASLD Practice Guidelines <ref name=Hepatology> AASLD guidelines for treatment of chronic hepatitis B. Hepatology (2016)http://onlinelibrary.wiley.com/doi/10.1002/hep.28156/full Accessed on October 10th, 2016</ref>== | ==Summary of Recommendations for Counseling and Prevention of Transmission of Hepatitis B from Individuals with Chronic HBV Infection: AASLD Practice Guidelines <ref name=Hepatology> AASLD guidelines for treatment of chronic hepatitis B. Hepatology (2016)http://onlinelibrary.wiley.com/doi/10.1002/hep.28156/full Accessed on October 10th, 2016</ref>== | ||
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==References == | ==References == | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Gastroenterology]] | |||
[[Category:FinalQCRequired]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Hepatology]] |
Latest revision as of 22:05, 29 July 2020
Hepatitis B |
Diagnosis |
Treatment |
Case Studies |
Hepatitis B secondary prevention On the Web |
American Roentgen Ray Society Images of Hepatitis B secondary prevention |
Risk calculators and risk factors for Hepatitis B secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Hepatitis B Immunoglobulin (HBIG) is a form of passive immunization when given shortly before or soon after exposure to hepatitis B virus. It is also administered in combination with HBV vaccines to the newborns of HBsAg positive mothers.[1][2]
Secondary Prevention
Hepatitis B Immunoglobulin
HBIG provides passively acquired anti-HBs and temporary protection (3-6 months) when administered in standard doses. HBIG is typically used as an adjunct to hepatitis B vaccine for postexposure immunoprophylaxis to prevent HBV infection. HBIG administered alone is the primary means of protection after an HBV exposure for nonresponders to hepatitis B vaccination.[1][2]
HBIG is similar to conventional IG preparations except that it is prepared from plasma preselected for a high titre of anti-HBs (>100 000 IU/ml of anti-HBs). The plasma is screened to eliminate donors who are positive for HBsAg, antibodies to HIV and hepatitis C virus (HCV), and HCV RNA:[1]
- HBIG protects by passive immunization if given shortly before or soon after exposure to HBV.
- The protection is immediate, but it lasts only 3 to 6 months.
- HBIG is not recommended as pre-exposure prophylaxis because of high cost, limited availability, and short-term effectiveness. HBIG is generally not affordable in developing countries.
- HBIG should be given to adults within 48 hours of HBV exposure.
- Maternal-neonatal transmission of HBV and the subsequent development of chronic hepatitis B in infected children is reduced drastically when HBIG is given to the newborn babies of HBV carrier mothers in conjunction with the first dose of the HB vaccine.
![](/images/9/9f/Prophylaxis_Algorythm.png)
Summary of Recommendations for Counseling and Prevention of Transmission of Hepatitis B from Individuals with Chronic HBV Infection: AASLD Practice Guidelines [4]
Class I |
"1. Newborns of HBV-infected mothers should receive HBIG and hepatitis B vaccine at delivery and complete the recommended vaccination series." |
Class IIb |
"2. Persons who are positive only for anti-HBc and who are from a low endemic area with no risk factors for HBV should be given the full series of hepatitis B vaccine." |
Class III |
"3. Carriers should be counseled regarding prevention of transmission of HBV." |
Class III |
"4. Sexual and household contacts of carriers who are negative for HBV seromarkers should receive hepatitis B vaccination." |
Class III |
"5. Persons who remain at risk for HBV infection such as infants of HBsAg-positive mothers, health care workers, dialysis patients, and sexual partners of carriers should be tested for response to vaccination.
|
Class III |
"6. Abstinence or only limited use of alcohol is recommended in hepatitis B carriers." |
References
- ↑ 1.0 1.1 1.2 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 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
- ↑ "WHO".
- ↑ AASLD guidelines for treatment of chronic hepatitis B. Hepatology (2016)http://onlinelibrary.wiley.com/doi/10.1002/hep.28156/full Accessed on October 10th, 2016