Combined passive and active immunoprophylaxis for preventing perinatal transmission of the hepatitis B virus in infants born to HBsAg positive mothers in comparison with vaccine alone

BACKGROUND: In order for liver cirrhosis and hepatocellular carcinoma not to be inflicted upon in infants' lifetime, it is essential to prevent hepatitis B virus (HBV) infection in them. OBJECTIVES: The aim of this study is to reveal the efficacy of passive and active immunoprophylaxis in preventing perinatal transmission of HBV in Iran. STUDY DESIGN: In this cohort study with historical controls, 823 children born to the HBsAg positive mothers were evaluated. Out of this number, 638 had received neither hepatitis B (HB) vaccine nor hepatitis B immune globulin (HBIG) and aged more than 16 years (n=481, group 1) or 16 years or less (n=157, group 2). The other 125 persons had received only HB vaccine (group 3), and 60 neonates received both HB vaccine and HBIG (group 4). RESULTS: The prevalence of HBsAg in groups 1, 2, 3 and 4 was 56.1%, 40.3%, 12.6%, and 3.6%, respectively. The prevalence of anti-HBsAb had a significantly descending rate in groups 4 (85.7%), 3 (68.8%), 2 (33.3%), and 1 (21.8%), respectively. CONCLUSIONS: The addition of HBIG to recombinant vaccine will significantly increase the protection against HBV infection in comparison with HB vaccine alone.