HepB Vaccine Combo May Prevent Mother-to-Child Transmission

One dose of 100 IU hepatitis B immunoglobulin (HBIG) at birth, in combination with the hepatitis B vaccine series (HepB), may prevent mother-to-child transmission of hepatitis B virus (HBV) among infants born to hepatitis B surface antigen (HBsAg)-positive mothers, according to a recent study.

For their study, the researchers evaluated mother-infant pairs with positive maternal HBsAg from 2009 to 2011. Infants were randomly assigned to receive either 1 dose of 100 IU HBIG (n = 545) or 200 IU HBIG (n = 632) within 12 hours of birth based on maternal numbering, followed by completion of the 3-dose 10 μg HepB series.
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Maternal and birth characteristics were comparable between infants in each cohort. Post-vaccination serologic testing (PVST) was performed among infants at 7 months.

A total of 451 of 545 infants from the first cohort and 529 of 632 from the second cohort were followed up to 12 months. Results of the study showed that, by 7 months, perinatal infection had occurred in 8 (1.5%) participants who had received 100 IU HBIG compared with 12 (1.9%) participants who had received 200 IU HBIG. In addition, 1 non-responding infant who had received 200 IU HBIG became newly infected at 12 months.

At 7 months, 529 (98.5%) participants in the 100 IU HBIG cohort had tested positive for the antibody to HBsAg, compared with 609 (98.2%) in the 200 IU HBIG cohort. At 12 months, these figures were 431 (98.2%) in the 100 IU HBIG cohort and 496 (97.1%) in the 200 IU HBIG cohort.

The researchers noted that the geometric mean concentrations of the antibody to HBsAg was comparable between cohorts at 7 months (707.95 mIU/mL vs 602.56 mIU/mL) and 12 months (245.47 mIU/mL vs 229.09 mIU/mL).

“One birth dose of 100 IU HBIG, combined with the HepB series, might be enough for preventing [mother-to-child transmission] of HBV in infants born to HBsAg-positive mothers,” the researchers concluded.

—Christina Vogt

Reference:

Wei KP, Zhu FC, Liu JX, et al. The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus: a prospective cohort study. Vaccine. 2018;36(2):256-263. https://doi.org/10.1016/j.vaccine.2017.11.037.