Hepatitis B Prevention

Dr. Parang Mehta, MD.

Hepatitis B is a common infection worldwide.  About a quarter of people who have this infection develop severe hepatitis or cirrhosis and die from it.  Hepatitis B infection also causes liver cell cancer.  This virus is the second most common known cause of human cancers.  Treatment for this infection is unsatisfactory at present, and avoidance of infection is important.

Hepatitis B virus infection is transmitted in a number of ways.

The hepatitis B vaccine will, of course, protect a person against the infection, whatever the source.  However, some other measures are important, and should be followed, even by people who have received the vaccine.

Preventive Measures Against Hepatitis B

The hepatitis B vaccine is most commonly taken by children and health care workers.  Since the vaccine became available, hepatitis B infection rates have fallen tremendously in these two groups.  Hepatitis B vaccine is the single most effective preventive measure against this disease.  The other measures are:

Hepatitis B Vaccine

A safe, effective vaccine against the hepatitis B virus is available.  Its use in national immunisation programs has reduced the carrier pool in many countries.

This vaccine should be given to all children, and can also be taken by adults.  Since blood transfusion is a risk factor for getting hepetitis B infection, children who require frequent blood transfusions or blood products must be given this vaccine.   It is also recommended for adults whose work puts them at risk -- hospital and laboratory employees, doctors, etc.

Hepatitis B vaccination requires three doses -- once as soon after birth as possible, the second dose after a month, and the third dose five months after the second.  If the vaccine has not been given in childhood, it can also be given to adolescents and adults.  This vaccine must never be given into the buttock or hip -- doing so reduces its efficacy.   It has to be given into the thigh in children, and into the shoulder in adolescents and adults.

Hepatitis B Immunoglobulin

Hepatitis B immunoglobulin (HBIG) is a product of the human body.  People who have had hepatitis B infection in the past have antibodies to the virus in their bloodstream.  HBIG is obtained from the blood of such people, and purified, processed to reduce chances of infection transmission, and given by injection.

The hepatitis B vaccine stimulates the body to produce antibodies against the hepatitis B virus.  The protection is therefore long term, perhaps lifelong.  HBIG offers preformed antibodies, and the immunity conferred lasts only a few weeks.  The advantages of HBIG over the vaccine is that protection is provided immediately.  It is especially valuable in preventing the transmission of infection from mother to baby at birth.

Mother to Child Transmission

Many children, especially in developing countries, get hepatitis B infection from their mothers who are infected.  This infection mostly takes place at time of birth.  Infection at this young age is usually associated with long term infection.  While adults who get hepatitis B infection usually have a short illness and then get rid of the virus, babies who are infected almost all go on to become chronic carriers.

Fortunately, protection is now available, in the form of the hepatitis B vaccine, and the hepatitis B immunoglobulin (HBIG).  These two measures can be used to give specific protection to infants born to women who are carriers.   These women should be identified through testing of all pregnant women.   The hepatitis B vaccine and Hepatitis B immunoglobulin should be kept in readiness at time of delivery, and administered to the baby as soon after birth as possible.  Only about three percent of children will get the infection, if these two measures have been taken.

 

Hepatitis B in Children

 

Last Revision: May 22, 2020