Effectiveness of hepatitis B vaccination in children of chronic hepatitis B mothers.
OBJECTIVE
Although all newborns in Iran have been vaccinated against hepatitis B since March 1993, routine screening of pregnant women has not been conducted in prenatal care programs, yet transmission of hepatitis B via the maternal-fetal route is still a viable likelihood, which must be entertained.


METHODS
The subjects were divided into 2 groups. The exposed group comprised 97 vaccinated children whose mothers were seropositive for hepatitis B surface antigen (HBsAg) and had not received hepatitis immunoglobulin at birth. The unexposed group consisted of 87 vaccinated children whose mothers were seronegative for hepatitis B surface antigen. We compared these 2 groups to determine the efficacy of vaccine alone in high-risk children. This study was conducted in Tehran, Iran, from June 2002 to December 2002. All children were born after 1993.


RESULTS
Chronic infection (HBsAg positivity) was detected in 14.3% of children in the exposed group. There were no instances of chronic infection in the unexposed group (relative risk [RR]=13.48, 95% confidence intervals [CI] 1.8-100.02). Previous infection of hepatitis B (HBcAb positivity) was found in 29 (29.9%) children in the exposed group, but only one (1.2%) in the unexposed group (RR=26.01, 95% CI: 3.61-186.95). Immunity (HBsAb positivity) in the exposed group measured 48 (49.5%) and unexposed group measured 56 (64.4%) (R.R=0.76, 95% CI: 0.59-0.99).


CONCLUSIONS
Vaccination alone did not induce immunity against hepatitis B in high-risk children; it seems that routine screening of pregnant women is necessary for determining whether neonates need hepatitis B immunoglobulin after birth.
Adibi
Peyman
P
Research Center for Gastroenterology and Liver Diseases, Isfahan University of Medical Sciences, Isfahan, Iran. adibi@med.mui.ac.ir
Ghassemian
Rezvan
R
Alavian
Seyed-Moayed
SM
Ranjbar
Mitra
M
Mohammadalizadeh
Amir H
AH
Nematizadeh
Fariborz
F
Mamani
Mojgan
M
Rezazadeh
Mahdi
M
Keramat
Fariba
F
Ardalan
Ali
A
Esmaeili
Abbas
A
Zali
Mohammad R
MR
D017677:Age Distribution; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007492:Iran / Q000453:epidemiology; D008297:Male; D009010:Monte Carlo Method; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D015995:Prevalence; D011322:Primary Prevention / Q000379:methods; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D014611:Vaccination / Q000592:standards*
D017325:Hepatitis B Vaccines