Zdravniški Vestnik (Nov 2002)
THE EFFECTIVENESS OF PROPHYLACTIC MEASURES AGAINST HEPATITIS B IN NEWBORNS OF HBsAg POSITIVE MOTHERS FOR THE PERIOD 1997–2002 IN CELJE REGION
Abstract
Background. There are about 400 million hepatitis B carriers in the world, of these some 20,000 live in Slovenia. Due to the low prevalence of chronic hepatitis B carriers in our country, the infection is most frequently transmitted by means of sexual intercourse with an infected person, or parenterally, by blood. Perinatal transmissions from an infected mother to her child which represent the most frequent infection route in the hyperendemic regions of Asia and Africa, should not be ignored either.Methods. A retrospective study was carried out at the Department for Infectious Diseases and Febrile Conditions of the General Hospital Celje with the aim to assess the success of postnatal and later prophylaxis of children against hepatitis B infection for the period 1997– 2002. Children aged 1–5 years were examined using clinical, biochemical and virological tests for hepatitis B, hepatitis C and HIV.Results. We examined 23 out of 33 invited HBsAg positive mothers and their children, who received immediate postnatal prophylaxis with specific immunoglobulins and vaccination against hepatitis B. Afterwards they received two additional vaccinations in a Pediatric Clinic or in an Institute of public health Celje. At the time of follow-up examination none of the children had positive serum markers for active viral infection with hepatitis B, hepatitis C and HIV. All the children had sufficiently high titers of protective antibodies against hepatitis B virus present in the serum (> 10 IU/ml). AgHBs became negative in one mother only while the rest remained asymptomatic carriers of hepatitis B virus. Consequently no treatment was required.Conclusions. Regardless of the outstandingly favorable results of postnatal prophylaxis against hepatitis B in our study subjects, the small number of children receiving this protection and the short follow-up period do not allow any long-term prognoses. Considering the high titers of protective antibodies in most of children, we presume that further revaccinations will not be necessary. The programs of preschool children screenings should also include follow-up tests for hepatitis B in children of HBsAg positive mothers who have received prophylaxis against hepatitis B after delivery. Early vaccination against hepatitis B of the whole preschool children population, which has been practiced in our country since 1998, will help to prevent many asymptomatic chronic and advancing infection with hepatitis B virus already in early childhood.
