I. Hepatitis B vaccine prevention Vaccination against hepatitis B is the most effective method to prevent HBV infection. The target population of hepatitis B vaccination is mainly newborns [37], followed by infants and children, unimmunized people under 15 years of age and high-risk groups
(e.g., medical personnel, those who are frequently exposed to blood, staff of childcare institutions, organ transplant patients, frequent recipients of blood transfusions or blood products, immunocompromised persons, persons prone to trauma, family members of HBsAg-positive persons, men who are gay or have multiple sexual partners, and intravenous drug users). Three doses of hepatitis B vaccine are required for the entire course, according to the 0, 1 and 6 months procedure, i.e., after the first dose of vaccine, the second and third doses of vaccine are given at intervals of 1 month and 6 months. Hepatitis B vaccination for newborns is required within 24 hours after birth.
The earlier the better, the better. The site of vaccination is intramuscular in the lateral anterior gluteal muscle for newborns and intramuscular in the middle deltoid muscle of the upper arm for children and adults. The blockage rate of mother-to-child transmission with hepatitis B vaccine alone was 87.8%. Newborns of HBsAg-positive mothers should be given hepatitis B immunoglobulin (HBIG) as early as possible (preferably 12 h after birth) within 24 h of birth
(HBIG) at a dose of ≥100 IU, along with 10 μg recombinant yeast or 20 μg Chinese hamster oocytes (CHO) at different sites
Hepatitis B vaccine, with 2nd and 3rd doses at 1 and 6 months of age, respectively, significantly improves the effectiveness of interruption of mother-to-child transmission [37, 38] (II-3). It can also be administered 12
HBIG within 12 h of birth, followed by a second dose of HBIG 1 month later, and a 10 μg recombinant yeast or 20 μg CHO vaccine at different sites at the same time.
CHO hepatitis B vaccine at 1 and 6 months intervals and a second and third dose of hepatitis B vaccine, respectively [39]. Neonates were given HBIG and hepatitis B vaccine at 12
h after HBIG and hepatitis B vaccine administration, can receive breastfeeding from HBsAg-positive mothers. Newborns of HBsAg-negative mothers can be given 5 μg or 10 μg yeast or 10 μg
CHO hepatitis B vaccine; children who did not receive hepatitis B vaccine as newborns should be given a catch-up dose of 5 μg or 10 μg recombinant yeast or 10 μg
CHO hepatitis B vaccine; for adults, 20 μg of yeast or 20 μg of
CHO hepatitis B vaccine for adults. For those who are immunocompromised or non-responders, the vaccination dose (e.g. 60 μg) and number of doses should be increased; for those who do not respond to the 3-dose immunization program, they can receive 3 more doses and have their serum tested for anti-HBs 1 to 2 months after the second 3-dose hepatitis B vaccine, and if they still do not respond, they can receive a 60 μg recombinant yeast hepatitis B vaccine. The protective effect of those with antibody response after hepatitis B vaccination generally lasts for at least 12 years [42]; therefore, anti-HBs monitoring or booster immunization is not required for the general population. However, anti-HBs surveillance can be performed in high-risk groups, and if anti-HBs is <10
mIU/mL, booster immunization can be given. Second, cut off the means of transmission and vigorously promote safe injection
(including needles for acupuncture), and strictly follow the standard protective principles in hospital infection management. The instruments used in the service industry such as haircut, shaving, pedicure, piercing and tattoo should also be strictly disinfected. Pay attention to personal hygiene and do not share supplies such as razors and dental appliances with anyone. Provide proper sex education. If the sexual partner is HBsAg positive, he/she should be vaccinated against hepatitis B or use condoms; always use condoms to prevent hepatitis B and other blood-borne or sexually transmitted diseases when the health status of the sexual partner is unknown. For HBsAg-positive pregnant women, avoid amniocentesis and shorten the delivery time to ensure the integrity of the placenta and minimize the exposure of the newborn to maternal blood. 3. HBV prophylaxis after accidental exposure After accidental exposure to the blood and body fluids of HBV-infected patients, the following methods can be followed: 1. Serological testing should be done immediately for HBV DNA, HBsAg, anti-HBs, HBeAg, anti-HBc, ALT and AST, and retested within 3 and 6 months. 2. Active and passive immunization, if hepatitis B vaccine has been given and anti-HBs ≥10
mIU/mL, no special treatment may be performed. If you have not received hepatitis B vaccine, or have received hepatitis B vaccine but anti-HBs <10 mIU/mL or the level of anti-HBs is unknown, you should immediately inject HBIG
200~400 IU and one dose of hepatitis B vaccine (20 mg) at different sites at the same time, and the second and third doses of hepatitis B vaccine (20 mg each) after 1 and 6 months, respectively. IV. Management of patients and carriers When acute or chronic hepatitis B is diagnosed, it should be reported to the local Center for Disease Control and Prevention as required, and it is recommended that family members of the patient be tested for serum HBsAg, anti-HBc and anti-HBs, and that susceptible individuals among them
(those who are negative for all three markers) to receive hepatitis B vaccine. The infectivity of hepatitis B patients and carriers depends mainly on the level of HBV DNA in the blood, but not on serum ALT, AST or bilirubin levels. For chronic HBV carriers and HBsAg carriers, they can work and study as usual, except that they cannot donate blood, tissues and organs and engage in occupations or types of work specified by the state, but they should have regular medical follow-ups.