title: Hepatitis B (HB) immunoglobulin plus HB vaccine for intrauterine HB virus infection.
abstract: BACKGROUND
  Vaccination against hepatitis B virus (HBV) infection in infants born to hepatitis B surface antigen (HBsAg)-positive mothers using HB immunoglobulin (HBIG) and hepatitis B (HB) vaccine was launched in Japan in 1985. Infants testing positive for HBsAg at 1 month of age are considered to have prenatally acquired the infection and are usually excluded from the prevention program. Infants born to HB e antigen (HBeAg)-positive mothers are at a high risk of perinatally acquiring the infection. In this study, long-term outcome was evaluated in children with prenatal HBV infection who received the HBIG and HB vaccine in Japan.
  
  
  METHODS
  Newborns of both HBsAg- and HBeAg-positive carrier mothers received HBIG within 48 h of birth and at 2 months of age. Subsequently, three doses of recombinant HB vaccine were given at 2, 3, and 5 months of age. Outcome was compared between the following two groups: infants who completed the vaccination program, even if they were HBsAg positive at 1 month of age (n = 15), and infants who did not (n = 51).
  
  
  RESULTS
  Seroconversion from HBeAg to anti-HBe antibody (HBeAb) before 3 years of age was observed in five children (33%) who completed the vaccination program and in two (4%) who did not (P = 0.005). In 2/5 children who completed the vaccination program and achieved HBeAb seroconversion, seroconversion from HBsAg to anti-HBs antibody was also noted.
  
  
  CONCLUSIONS
  This specific vaccination program for children with prenatal HBV infection has the potential to alter immune tolerance to HBV.
authors.affiliation: Division of Hepatology and Gastroenterology, Children's Center for Health and Development, Saiseikai Yokohamashi Tobu Hospital, Sakura, Chiba, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Iwasawa
authors.affiliation: Division of Hepatology and Gastroenterology, Children's Center for Health and Development, Saiseikai Yokohamashi Tobu Hospital, Sakura, Chiba, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Inui
authors.affiliation: Division of Hepatology and Gastroenterology, Children's Center for Health and Development, Saiseikai Yokohamashi Tobu Hospital, Sakura, Chiba, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsunoda
authors.affiliation: Division of Hepatology and Gastroenterology, Children's Center for Health and Development, Saiseikai Yokohamashi Tobu Hospital, Sakura, Chiba, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Division of Hepatology and Gastroenterology, Children's Center for Health and Development, Saiseikai Yokohamashi Tobu Hospital, Sakura, Chiba, Japan.
authors.forename: Manari
authors.initials: M
authors.lastname: Kawamoto
authors.affiliation: Division of Hepatology and Gastroenterology, Children's Center for Health and Development, Saiseikai Yokohamashi Tobu Hospital, Sakura, Chiba, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sogo
authors.affiliation: Department of Pediatrics, Sakura Hospital, Toho University Schowol of Medicine, Sakura, Chiba, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Komatsu
authors.affiliation: Division of Hepatology and Gastroenterology, Children's Center for Health and Development, Saiseikai Yokohamashi Tobu Hospital, Sakura, Chiba, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Fujisawa
mesh_terms: D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000628:therapy* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000235:genetics / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage*; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin
keywords: fetomaternal infection; hepatitis B; immunotherapy; perinatal care; transmission; vaccine