Marité Bello, Licel de los Angeles Rodríguez, Maura Nazco, Montalvo MC, Sariego S, Verdasquera D, Pedroso P, Bermúdez Y, Sánchez M

Language: Spanish
References: 20
Page: 24-30
PDF size: 107.10 Kb.

ABSTRACT

The joint administration of the anti-hepatitis B gammaglobulin and the vaccine is worldwide recommended for the prevention of perinatal transmission to children from HBsAg(+) mothers. As a preventive measure of transmission, passive-active immunization was evaluated after 3 days and at 7 and 18 months of life. Eighty-seven sera from children from HBsAg(+) mothers were studied; these sera were collected 3 days, and 7 and 18 months after birth, for a total amount of 261 samples. Newborns were administered a dose of Cuban Human Anti-hepatitis B Immunoglobulin (Ganmahep B) and a dose of the Cuban recombinant vaccine Heberbiovac-HB® before the first 12 hours after birth. Afterwards, the vaccination scheme at months 1, 2, and 12 was followed. Children were evaluated with HBsAg and anti-HBs markers. At the third day, 8.0% of the children were HBsAg(+); the 92.5% of HBsAg(-) children turned out to be seroprotected. At 7 months of age, 1.1% was HBsAg(+), seroprotection of HBsAg(-) children was 89.5%. At 18 months of age, 3.4% was HBsAg(+), with a 97.6% of protection of HBsAg(-) children. The normoprotective response was predominant at the three periods of time, with statistically significant differences in seroprotection and titers =100 UI/L. Geometric Mean Titer (GMT) values were 72.9 UI/L, 168.66 UI/ L and 175.62 UI/L, respectively, with statistical significance among them. It is suggested that the use of Ganmahep B, along with the administration of the Cuban vaccine reduces the risk of HBV perinatal transmission and this is the first study carried out in Cuba to evaluate the prophylactic efficacy within this risk group.

REFERENCES

1. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11:97-107.

2. Xu WM, Cui YT, Wang L, Yang H, Liang ZQ, Li XM, et al. Lamivudine in late pregnancy to prevent perinatal transmissionof hepatitis B virus infection: a multicentre, randomized, doubleblind, placebo-controlled study. J Viral Hepatol 2009;16:94-103.

3. Milne A, West JD, Chinh DV, Moyes ChD, PoerschikeG. Field evaluation of the efficacy and immunogenicity of recombinanthepatitis B vaccine without HBIG in newborn Vietnamese infants. J Med Virol 2002;67(3):327-33.

4. Rodríguez L, Bello M, Delgado G, Gutiérrez A, Díaz M, Montalvo MC, et al. Eficacia de la inmunización en lactantes de alto riesgo de infección por el virus de la hepatitis B. Experiencia cubana. Saludarte 2006;4(3):188-93.

5. Kuru U, Turan O, Kuru N, Saglam Z, Alver A. Results of vaccinated infant born to HbsAg positive mathers with different hepatitis doses. Turk Pediatr 1995;37(2):93-102.

6. Bello M, Rodríguez L, Díaz M, Lai R, Delgado G, Montalvo MC, et al. Marcadores serológicos en lactantes de alto y bajo riesgo de infección por el virus de la hepatitis B inmunizados con unavacuna recombinante cubana. Rev Pediátrica 2006;8(1):7-14.

7. Eto T, Shiraki K. National proyect on the prevention of mother to infant infection by hepatitis B virus in Japon. PediatricsInternational 1989;31(6):681-4.

8. Díaz M, Rodríguez L, Delgado G, Pedroso P, Díaz B, Bravo JR. Efectividad de la vacuna Heberbiovac-HB® en niños hijos de madres positivas al AgsHB. Av Biotecnol Mod 1997;14(4):37.

9. Rodríguez L, Díaz M, Delgado G, Pedroso P, Bravo J. Eficacia de la vacuna Heberbiovac-HB® en hijos de madres positivas al AgsHB. 7 años de seguimiento (1992-1997). Av Biotecnol Mod. 1999;5:46.

10. Bello M, Rodríguez L, Delgado G, Díaz M, Montalvo MC. Vigilancia de los hijos de madres positivas al antígeno desuperficie de hepatitis B, 2000-2002. Rev Cub Med Trop 2004;56:31-4.

11. Yang YJ, Liu CC, Chen TJ, Lee MF, Chen SH, Shih HH, et al. Role of hepatitis B inmunoglobulin in infants born to hepatitis B e antigen - negative carrier mothers in Taiwan. Pediatr Infect Dis J 2003;22(7):584-8.

12. Esteban JI, Genesca J, Esteban R, Hernandez JM, Seijo G, Buti M. et al. Immunoprophylaxis of perinatal transmission of the hepatitis B virus: efficacy of hepatitis B immune globulin and hepatitis B vaccine in a low-prevalence area. J Med Virol 1986;18(4):381-91.

13. Bello M, Rodríguez L, Delgado G, Gutiérrez A, Montalvo MC, Sariego S, et al. Resultados de la vigilancia de los hijos de madres positivas al antígeno de superficie del virus de la hepatitis B (HBsAg) 2000-2007. En: Delgado G, editor. Taller Nacional de Hepatitis; Junio 17-18; La Habana, Cuba: Vicedirección de Higiene y Epidemiología, MINSAP; 2008.

14. Cladd ES, Taylor PE, Ton MJ. Yeast Recombinant hepatitis B vaccine eficcacy with Hepatitis B inmune Globuline in prevention of perinatal hepatitis B virus transmission. JAMA 1987;257(19):2612-6.

15. Chen DS, Hsu HM, Bennett CL, Pajeau TS, Blumberg B, Chang PY, et al. A program for eradication of hepatitis B from Taiwan by a 10 years, four – dose vaccination program. Cancer causes Control 1996;3:305-11.

16. Davis AR, Brotchie HL, Mundkur BA, Ismay SL. Transient hepatitis B surface antigenemia in a blood donor after a combination hepatitis A and B vaccine. Transfusion 2003;43:545.

17. Zanetti AR, Dentico P, Blanco CV, Sagnelli E, Villa E, Ferroni P, et al. Multicenter trial on the eficacy of HBIG and vaccine in preventing perinatal hepatitis B. J Med Virol 1986;18(4):327- 34.

18. Wheeley SM, Jackson PT, Boxall EH, Tarlow MJ, Gatrad AR, Anderson J, et al. Prevention of perinatal transmission of hepatitis B virus (HB V): A comparison of two prophylactic schedules. J Med Virol 1991;25(3):212-5.

19. Poovorawan Y, Sanpavat S, Chmdermpadetsuk S, Safary A. Long term hepatitis B vaccine in infants born to hepatitis B e antigen positive mothers. Arch Dis Child: Fetal & Neonatal 1997;77:47-51.

20. Jafarzadeh A, Zarei S, Shokri F. Low dose revaccination induces robust protective anti-HBs antibody response in the majority of healthy non-responder neonates. Vaccine 2008;26(2):269- 76.