Hepatitis B/Primary Prevention

Page has default form::MedicalTherapy {{#meta: itemprop="medicalWebPageAudiences" content="patient"}}{{#meta: itemprop="medicalWebPageSpecialities" content="cardiology"}}{{#meta: itemprop="medicalWebPageInfoTypes" content="symptoms,diagnosis,treatment,causes,prognosis,complications"}}

Overview

Hepatitis Main Page
Hepatitis B
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Hepatitis B from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Ultrasound
Treatment
Medical Therapy
Surgery
Primary Prevention
Hepatitis B Vaccination
Hepatitis B Vertical transmission
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Hepatitis B/Primary Prevention On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Hepatitis B/Primary Prevention All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hepatitis B/Primary Prevention
CDC on Hepatitis B/Primary Prevention
Hepatitis B/Primary Prevention in the news
Blogs on Hepatitis B/Primary Prevention
Directions to Hospitals Treating Hepatitis B
Risk calculators and risk factors for Hepatitis B/Primary Prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2], Sara Mehrsefat, M.D. [3]

Overview

The risk of transmission of hepatitis B may be reduced by the implementation of certain measures proposed by the WHO. These include the vaccination of all infants within 24 hours of birth; vaccination of members of certain risk groups, including travelers to endemic areas and healthcare workers (if they have not been vaccinated yet); avoidance of sexual contact with a person who has acute or chronic hepatitis B; and avoiding sharing personal items such as razors or toothbrushes. The HBV vaccine is effective in preventing HBV infections when it is administered either before exposure or shortly after exposure.

Primary Prevention

According to the WHO, the following measures should be implemented to prevent infection by hepatitis B virus:

Primary Prevention	Recommendations
Hepatitis B vaccine	The hepatitis B vaccine is the mainstay of hepatitis B prevention The complete vaccine series induces protective antibody levels in more than 95% of infants, children, and young adults Protection lasts at least 20 years and may be lifelong WHO recommends vaccination for: All infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours The birth dose should be followed by 2 or 3 doses to complete the primary series. In most cases, 1 of the following 2 options is considered appropriate: All children and adolescents younger than 18 years old who have not previously been vaccinated should receive the vaccine People who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantations Incarcerated people Injection drug users Household and sexual contacts of people with chronic HBV infection People with multiple sexual partners, as well as health-care workers and others who may be exposed to blood and blood products through their work Travellers who have not completed their hepatitis B vaccination series should be offered the vaccine before leaving for endemic areas
Screening of all donated blood	Screening of all donated blood has reduced the chance of getting hepatitis B from a blood transfusion.
Hepatitis B immune globulin	The hepatitis B immune globulin (HBIG) or hepatitis B vaccine shot may help prevent hepatitis B infection if it is administered within 24 hours of exposure
Lifestyle measures	Avoid sexual contact with a person who has acute or chronic hepatitis B Use a condom and practice safe sex Avoid sharing personal items such as razors or toothbrushes Do not share drug needles or other drug equipment (such as straws used for snorting drugs) Clean blood spills with a solution containing 1 part household bleach for every 10 parts water

Patients with chronic hepatitis B should be aware of the following:

Education and Prevention of Hepatitis B

Importance of lifestyle modifications (e.g., reduction of alcohol consumption) Risk of transmission to others: Household memebers with negative test results for HBV serologic markers should be vaccinated. Regular sexual partners with negative test results for HBV serologic markers should be vaccinated. Casual sexual partners or unvaccinated regular sexual partners should make use of barrier protection methods. Pregnant HBsAg-positive women should inform their healthcare providers so that Hepatitis B Immune Globulin and hepatitis B vaccine may be administered to the infant after delivery. Healthcare workers infected with hepatitis B should consult an expert review panel. In case of organ transplant in which anti-HBc-positive organ donors are used for HBV seronegative recipients, HBV infection should be prevented with the administration of antiviral therapy. 6-12 months of prophylactic therapy may be sufficient for organ transplants other than hepatic. For hepatic transplants, life-long antiviral therapy is recommended.

Vaccination

Hepatitis B vaccine is the most effective tool in preventing the transmission of HBV and HDV. Vaccines are composed of the surface antigen of HBV (HBsAg), and are produced by two different methods: plasma-derived and recombinant DNA. The natural reservoir for hepatitis B virus is man. Closely related hepadnaviruses have been found in woodchucks and ducks, but they are not infectious for humans.

The primary hepatitis B immunization series conventionally consists of three doses of vaccine. Vaccination of infants and, in particular, delivery of hepatitis B vaccine within 24 hours of birth is 90–95% effective in preventing infection with HBV as well as decreasing HBV transmission if followed by at least two other doses. WHO recommends universal hepatitis B vaccination for all infants and specifies that the first dose should be given as soon as possible after birth. This strategy has resulted in a dramatic decrease in the prevalence of CHB among young children in regions of the world where universal infant vaccination programs have been implemented. A small proportion of vaccinated children (5–10%) have a poor response to vaccination and remain susceptible to acquisition of HBV infection throughout their lives.

WHO recommends that hepatitis B vaccine be included in routine immunization services in all countries. The primary objective of hepatitis B immunization is to prevent chronic HBV infections, which result in chronic liver disease later in life. By preventing chronic HBV infections, the major reservoir for transmission of new infections is also reduced.

For hepatitis B vaccine, see Hepatitis B vaccine.

References

Template:WH Template:WS

Related Pages

• Adverse Outcomes:
• Contraindications:
• Duplicate Therapies:
• Indications: {{:}}
• Prevents:Prevents::Hepatitis B
• Treats: