Hepatitis B Vaccine Prophylaxis (Chronic Hepatitis B Control Guidelines 2010 Update)

Hepatitis B vaccination is the most effective way to prevent HBV infection. Hepatitis B vaccination is mainly for newborns, followed by infants and young children, unimmunized people under the age of 15, and high-risk groups (such as medical personnel, people who often come into contact with blood, workers in child care institutions, organ transplant patients, people who often receive blood transfusions or blood products, immunocompromised people, people prone to traumatic injuries, family members of HBsAg-positive people, male homosexuals or people with multiple sexual partners, and people who inject drugs into the vein). (e.g. people who inject drugs into the vein, etc.). Hepatitis B vaccination consists of 3 doses, according to the program of 0, 1, 6 months, i.e. after the first vaccination, the second and third vaccines are given at intervals of 1 and 6 months. Newborns should be vaccinated with hepatitis B vaccine as early as possible, within 24 hours after birth. The vaccination site is intramuscular in the anterior lateral thigh for newborns, and intramuscular in the middle deltoid muscle of the upper arm for children and adults. The protection rate of mother-to-child transmission with hepatitis B vaccine alone is 87.8% [26] (II-3). An Yong, Department of Hepatology, Qianfoshan Hospital, Shandong Province Hepatitis B immunoglobulin (HBIG) should be administered to newborns of HBsAg-positive mothers as early as possible, preferably within 12 h after birth, at a dose of ≥100 IU, and 10 μg of recombinant yeast or 20 μg of Chinese hamster oocyte (CHO) Hepatitis B vaccine should be administered to the different sites at the same time, and the second and third injections should be administered at 1 and 6 months, respectively. Hepatitis B vaccination at 1 and 6 months of age with the 2nd and 3rd doses of hepatitis B vaccine, respectively, significantly improves the efficacy of interruption of mother-to-child transmission (II-3). Alternatively, one dose of HBIG can be given within 12 h of birth, followed by a second dose of HBIG one month later, and a single dose of 10 μg of recombinant yeast or 20 μg of CHO Hepatitis B Vaccine at different sites, with second and third doses of Hepatitis B Vaccine given at intervals of one and six months, respectively. Newborns can be breastfed by HBsAg-positive mothers after receiving HBIG and hepatitis B vaccine within 12 h of birth[29] (III). Neonates born to high viral load pregnant women are at increased risk of HBV infection. Administration of antiviral therapy with lamivudine to pregnant women from 32 weeks of gestation until the first month of life has been reported to reduce the risk of mother-to-child transmission in pregnant women with HBVDNA greater than 109 copies/mL. However, a definitive recommendation cannot be given until more adequate evidence is available. Neonates of HBsAg-negative mothers can be immunized with 5 μg or 10 μg of recombinant yeast or 10 μg of CHO hepatitis B vaccine; children who were not vaccinated against hepatitis B in the neonatal period should be given catch-up vaccination with 5 μg or 10 μg of recombinant yeast or 10 μg of CHO hepatitis B vaccine; and 20 μg of recombinant yeast or 20 μg of CHO hepatitis B vaccine is recommended for adults. For immunocompromised or non-responders, the vaccine dose (e.g., 60 μg) and number of injections should be increased; those who do not respond to the 3-dose immunization program can receive another 3 doses, and serum anti-HBs can be detected 1-2 months after the second 3 doses of Hepatitis B vaccine; if there is still no response, a single injection of 60 μg of recombinant yeast Hepatitis B vaccine can be given. The protective effect of hepatitis B vaccine for those who respond with antibodies usually lasts for at least 12 years, so anti-HBs monitoring or booster immunization is not necessary for the general population. However, anti-HBs monitoring can be performed in high-risk groups, and booster immunization can be given if anti-HBs is < 10 mIU/ml[30] (III).