Essentials of immunoprophylaxis against hepatitis B in newborns

1, pregnant women need to be tested prenatal hepatitis B serological markers: HBsAg positive, indicating that HBV infection, infectious; HBeAg positive, highly infectious; anti-HBs positive, hepatitis B immunity. 2, pregnant women HBsAg negative: the newborn according to 0, 1, 6 months 3 injection program for hepatitis B vaccine, that is, within 24h of birth, 1 month and 6 months were vaccinated with 1 injection; do not have to be injected with HBIG. 3, pregnant women HBsAg positive: newborns are born within 12h, intramuscular injection of HBIG; at the same time, according to the 0, 1, 6 months 3 injection program of vaccination for hepatitis B vaccine. 4, HBsAg-positive pregnant women’s breastfeeding: after the newborn formal prevention, regardless of whether the pregnant woman HBeAg negative or positive, are feasible breastfeeding. 5, the mode of delivery and mother-to-child transmission: cesarean section delivery can not reduce the rate of mother-to-child transmission of HBV. Preterm infants: When the birth weight is ≥2000g, no special treatment is needed. When weight <2000g, the first vaccine injection should be given after the weight reaches 2000g, and then after an interval of 1~2 months, it should be implemented according to the program of 3 injections at 0, 1 and 6 months. When the pregnant woman is HBsAg negative and the preterm baby is in good health, the treatment will be as above; when the health condition is not good, the related diseases will be dealt with first, and then the vaccination will be given after recovery. HBsAg-positive pregnant women, regardless of the health status of preterm infants, intramuscular injection of HBIG within 12h, the interval of 3~4 weeks need to be injected again; within 24h of birth, 3~4 weeks, 2~3 months, and 6~7 months, respectively, the vaccine, and follow up. 7, other family members HBsAg-positive: if the newborn and HBsAg-positive members of close contact, must be injected with HBIG; not close contact, do not have to be injected. 8, HBsAg-positive pregnant women's newborn follow-up: 7 ~ 12 months, testing for hepatitis B serologic markers. If HBsAg negative, anti-HBs positive, prevention is successful, resistance; if HBsAg negative, anti-HBs negative, prevention is successful, but need to be vaccinated with 3 more vaccines; if HBsAg positive, prevention fails, and become chronically infected. 9, other precautions: any damage to the skin and mucous membranes before the operation, must be fully cleaned and disinfected before proceeding. 10, HBsAg-positive pregnant women whether anti-HBV treatment to reduce the rate of mother-to-child transmission: HBeAg-negative, no need for antiviral; HBeAg-positive, whether the anti-HBV treatment is inconclusive, the need for rigorous multi-center controlled studies.