Effectiveness of hepatitis B hyperimmunglobulin and vaccine in preventing perinatal transmission in children born from a mother with chronic B hepatitis





hepatitis B virus, hepatitis B vaccine, hepatitis B hyperimmunglobulin, perinatal transmission


Background. Viral hepatitis is still one of the important health problems all over the world today. Hepatitis B is a life-threatening liver infection that can cause chronic infections. It increases the risk of death from cirrhosis and hepatocellular carcinoma. One of the most important factors in chronic or acute hepatitis B infection is the age of infection. The earlier the virus is encountered, the greater the risk of chronicity of the disease. Prevention of perinatal transmission of the disease is of great importance. The most effective way to control hepatitis B infection is to prevent contamination and ensure immunity. There is a safe and effective vaccine available that provides 98–100% protection against hepatitis B. Prevention of hepatitis B infection control the development of complications, including chronic disease and liver cancer. The purpose of this study is to evaluate the efficacy of the vaccine and hepatitis immunoglobulin administered to prevent perinatal hepatitis B infection transmission in babies born to mothers with chronic hepatitis B infection. Materials and methods. Fifty-five children born to mothers with chronic hepatitis B infection in our hospital between January 1, 2013 and January 1, 2019 and accepted to participate in the study were included in our study. In retrospective file examination, maternal gestational age, maternal hepatitis B test, delivery method, baby birth weight, baby birth week, whether immunoglobulin and hepatitis B vaccine were administered to these babies in the first 24 hours after birth, hepatitis B vaccine and immunoglobulin administration time, bathroom status, infant hepatitis B tests, additional studies on the child’s viral diseases (hepatitis C, human immunodeficiency virus) and the baby’s liver transaminase tests (aspartate aminotransferase, alanine aminotransferase) were evaluated. The vaccination program of the baby, the control of the mother’s hepatitis B status, the time of the breast milk intake, the height and weight of the baby, the follow-up of the mother during pregnancy and the drug use status were collected. Children previously diagnosed with chronic B hepatitis were excluded from the study. Results. Hepatitis B surface antigen tests were positive in two infants who received three doses of hepatitis B vaccine. The mothers of both of these babies were positive for hepatitis B surface antigen and hepatitis B envelope antigen. Forty-three (78.2 %) patients had a protective antibodies to hepatitis B surface antigen, while 12 (21.8 %) didn’t have it. Conclusions. Hepatitis B serology should be checked in women who live in countries with high risk of chronic hepatitis B infection and who are pregnant, and babies born to these mothers should have hepatitis B vaccine and immunoglobulin.


World Health Organization. Hepatitis B: Fact Sheet. Available from: https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-b. Accessed: July 27, 2020.

Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 2004 Mar;11(2):97-107. doi:10.1046/j.1365-2893.2003.00487.x.

Lee WM. Hepatitis B virus infection. N Engl J Med. 1997 Dec 11;337(24):1733-1745. doi:10.1056/NEJM199712113372406.

Mast EE, Margolis HS, Fiore AE, et al. A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States. Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: Immunization of Infants, Children, and Adolescents. MMWR. 2005 Dec 23;54(16):1-32.

Ministry of Health of Turkey. General Directorate of Primary Health Care Services. Permanent Circular on the Extended Immunization Program 2009. Available from: https://www.saglik.gov.tr/TR,11137/genisletilmis-bagisiklama-programi-genelgesi-2009.html. Accessed: October 17, 2011. (in Turkish).

Mistik R, Balik I. The Epidemiologic Analyzes Viral Hepatitis in Turkey. In: Kılıçturgay K, Badur S, editors. Viral Hepatitis. İstanbul: Medikal Sağlık ve Yayıncılık; 2001. 10-55 pp. (in Turkish).

Tosun S. Epidemiology of viral hepatitis in Turkey: a meta-analysis of all published papers. In: Tabak F, Tosun S, editors. Viral Hepatitis. Istanbul: Tip Publisher; 2013. 27-79 pp. (in Turkish).

Aktuğ Demir N, Asan A, Ayaz C, et al. Management of Chronic Hepatitis B in Pregnancy: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases. Klimik Journal. 2013;26:12-19. doi:10.5152/kd.2013.14. (in Turkish).

Cunningham GF, Gant NF, Leveno KJ, et al. Gastrointestinal Disorders. In: Williams Obstetrics. 21st ed. New York: McGraw-Hill; 2001. 1273-1306 pp.

Tosone G, Maraolo AE, Mascolo S, Palmiero G, Tambaro O, Orlando R. Vertical hepatitis C virus transmission: Main questions and answers. World J Hepatol. 2014 Aug 27;6(8):538-548. doi:10.4254/wjh.v6.i8.538.

Yeung CY, Lee HC, Chan WT, Jiang CB, Chang SW, Chuang CK. Vertical transmission of hepatitis C virus: Current knowledge and perspectives. World J Hepatol. 2014 Sep 27;6(9):643-51. doi:10.4254/wjh.v6.i9.643.

American Academy of Pediatrics. Hepatitis B. In: Pickering LK, Baker CJ, Long SS, editors. Red Book 2006. Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, II: American Academy of Pediatrics; 2006. 335-355 pp.

Lee C, Gong Y, Brok J, Boxall EH, Gluud C. Effect of hepatitis B immunisation in newborn infants of mothers positive for hepatitis B surface antigen: systematic review and meta-analysis. BMJ. 2006 Feb 11;332(7537):328-336. doi:10.1136/bmj.38719.435833.7C.

Doğan Y, Aygun D, Akarsu S, Yılmaz E, Kabakuş N. The role of immunoprophylaxis in prevention of vertical transmission of hepatitis B infection in cases who were admitted to Fırat Medical Center. Turk Ped Arch. 2007;42:70-73. (in Turkish).

Beckers K, Schaad UB, Heininger U. Compliance with antenatal screening for hepatitis B surface antigen carrier status in pregnant women and consecutive procedures in exposed newborns. Eur J Pediatr. 2004 Nov;163(11):654-657. doi:10.1007/s00431-004-1522-x.

Chang MH. Natural history and clinical management of chronic hepatitis B virus infection in children. Hepatol Int. 2008 May;2(Suppl 1):28-36. doi:10.1007/s12072-008-9050-9.

Kao JH, Chen DS. Global control of hepatitis B virus infection. Lancet Infect Dis. 2002 Jul;2(7):395-403. doi:10.1016/s1473-3099(02)00315-8.

Tiollais P, Buendia MA. Hepatitis B virus. Sci Am. 1991 Apr;264(4):116-123.

Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008 Oct 2;359(14):1486-500. doi:10.1056/NEJMra0801644.

Kuru U, Turan O, Kuru N, et al. Prevalence of hepatitis B virus infection in pregnant Turkish women and their families. Eur J Clin Microbiol Infect Dis. 1996 Mar;15(3):248-251. doi:10.1007/BF01591364.

Euler GL, Copeland JR, Rangel MC, Williams WW. Antibody response to postexposure prophylaxis in infants born to hepatitis B surface antigen-positive women. Pediatr Infect Dis J. 2003;22(2):123-129. doi:10.1097/01.inf.0000048677.32881.fa.

Kaya S. Seroprevalance of hepatitis B virus, hepatitis C virus, human immunodeficiency virus infection and syphilis in blood donors. Klimik Journal. 2008;21(2):65-68. (in Turkish).

Araz NC, Dikensoy E. Seroprevalence of hepatitis B among pregnant women in southern Turkey. J Pak Med Assoc. 2011 Feb;61(2):176-177.

Köksaldı Motor V, Evirgen Ö, Aksakal M, Inci M, Önlen Y, Ocak S. Seropositivity of Hepatitis B and Hepatitis C in women who were admitted to Hatay Maternity and Children’s Hospital. Viral Hepat J. 2010;16(2):53-56. (in Turkish).






Clinical Pediatrics