Outcomes of passive-active immunoprophylaxis given to infants of mothers infected with hepatitis B virus in Babol, Iran

Abstract

Background: Infants born to chronic hepatitis B virus (HBV) infected mothers may be infected in spite of receiving passive-active immunoprophylaxis.

Objectives: The purpose of this study was to assess the outcome of infants born to women actively infected by HBV.

Study design: From April 2004 to September 2009, infants born to women actively infected by HBV received hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine at birth. The second and third doses of HBV vaccine were administered at 1 and 6 months of age. Post-vaccination tests to detect HBsAg and anti-HBs were assessed between 12 and 15 months of age. Those who had anti-HBs titers<10mIU/ml received the second series of HBV vaccine.

Results: Thirty-four and 201 infants were born to HBeAg-seropositive and anti-HBe-seropositive mothers, respectively. HBsAg was detected in 6 (17.6%) infants born to HBeAg-seropositive mothers and in 3 (1.5%) to anti-HBe-seropositive mothers (p=0.0001). Anti-HBs ≥ 10mIU/ml were achieved in 26 (76.5%) and 178 (88.6%) infants of HBeAg-seropositive and anti-HBe-seropositive mothers, respectively (p>0.05). Twenty-two (9.4%) infants were non-responders and 11(50%) of them responded to the second series of HBV vaccine.

Conclusions: The results show that infants of HBeAg-seropositive mothers have higher risk of developing of HBV infection. Some HBsAg-seronegative infants may not respond to passive-active immunoprophylaxis and may remain at risk of HBV infection.