hepatitis B prevention

[Guest danielirra]

Dear all, 
I need your feedback regarding the importance of maternal hepatitis B results to administer HBIG as soon as possible (ie if the delay 48-72 hours could diminish the effectiveness in preventing HB)

We have some problems during the weekend with our laboratory.

thanks in advance

Daniel

[Abdul kasim jaleel ahmed]

We also face this kind of problem 

Mehar is the evidence base if it get deleyed - effectiveness 

[M C Fadous Khalife]

A new article published in 2018 says that 2-5% of newborns from mothers infected with hepatitis B will be infected despite immediate vaccination and Ig ! But tgey don’t speak about the delay for IgHB .https://www.ncbi.nlm.nih.gov/m/pubmed/29688415/?i=15&from=Neonatal Hepatitis you can read it .may be it can help 

[M C Fadous Khalife]

if you want to be sure, try to reevaluate the newborns with delay of doing Ig ! But it must be at least 2-3 months after birth because surface HB ag must not be measured within 1 month of vaccination. 

It would even be interesting to try to measure surface antibodies and Ag to all these babies . 

We rarely do it . Do you do it for your babies? 

[Stefan Johansson]

Infants to mothers with "high-risk" status (HBeAg+, OR anti-HBeAg+  and high load of HBV-DNA), we administer immunoglobulin soon after birth. Since mothers are screened for chronic infections at the maternal antenatal care center, ab-status it is usually known at the time of delivery.

The pediatrician/neonatologist on call are informed over the telephone and the delivering midwife gives the injection.

Infants to mothers with "high-risk" status should be sampled at birth with regards to HBsAg and antiHBc (indicative for intrauterine infection), and at the age of 18 months the child is sampled for anti-HBs (vaccineffect) och HBsAg och antiHBc (detection of infection), as the risk of vertical infection is not eliminated despite postpartum proph and early vaccination.

@M C Fadous Khalife thanks for the recent reference!

[sueprul]

I know the US protocol but what are other countries doing. Giving within 24? The most recent from my volunteer country is to give IVIG (but not available) and they have 48 to get the vaccine in. Going to a protocol meeting next week if you can share your recommendations maybe I can get it changed. 

[Stefan Johansson]

@sueprul I found these two publications suggesting that vaccination alone would give a similar (same?) protection as vaccine+Ig

https://www.ncbi.nlm.nih.gov/pubmed/27894717

https://www.ncbi.nlm.nih.gov/pubmed/25362571

As said in a previous post, the Swe guidelines is to give Ig+Vaccine asap after birth (typically within the first hours).

[agoz]

hepatititis b immunglobulin how many units do you give ?

we give as soon as possible. in the first few hours

Just now, agoz said:

hepatititis b immunglobulin how many units do you give ?

we give as soon as possible. in the first few hours

 

[sueprul]

They recommend it here but is not really available. Also if the mother cannot but the full vial of vaccine it is not given. The vial is approximately $60. Tragic that it is known to be needed but generally not given due to cost to family

[agoz]

11 hours ago, agoz said:

hepatititis b immunglobulin how many units do you give ?

we give as soon as possible. in the first few hours