Hepatitis B vaccine: Difference between revisions
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The vaccine was originally prepared from plasma obtained from patients who had long-standing hepatitis B virus infection. However, currently, these are more often made using recombinant DNA technology, though plasma-derived vaccines continue to be used; the two types of vaccines are equally effective and safe.<ref name="pmid6997738">{{cite journal| author=Szmuness W, Stevens CE, Harley EJ, Zang EA, Oleszko WR, William DC et al.| title=Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. | journal=N Engl J Med | year= 1980 | volume= 303 | issue= 15 | pages= 833-41 | pmid=6997738 | doi=10.1056/NEJM198010093031501 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6997738 }} </ref> | The vaccine was originally prepared from plasma obtained from patients who had long-standing hepatitis B virus infection. However, currently, these are more often made using recombinant DNA technology, though plasma-derived vaccines continue to be used; the two types of vaccines are equally effective and safe.<ref name="pmid6997738">{{cite journal| author=Szmuness W, Stevens CE, Harley EJ, Zang EA, Oleszko WR, William DC et al.| title=Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. | journal=N Engl J Med | year= 1980 | volume= 303 | issue= 15 | pages= 833-41 | pmid=6997738 | doi=10.1056/NEJM198010093031501 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6997738 }} </ref> | ||
*Plasma | *Plasma | ||
* | *Recombinant | ||
**Yeast-derived recombinant | **Yeast-derived recombinant | ||
** | **Mammalian cell-derived recombinant | ||
===Vaccination recommendation=== | ===Vaccination recommendation=== | ||
Revision as of 19:26, 4 October 2016
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Hepatitis B |
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Diagnosis |
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Treatment |
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Hepatitis B vaccine On the Web |
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American Roentgen Ray Society Images of Hepatitis B vaccine |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Hepatitis B Vaccine
Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences. Since they were first issued in 1982, recommendations for hepatitis B vaccination have evolved into a comprehensive strategy to eliminate HBV transmission in the United States.[1][2]
Recombinant DNA-derived vaccines against HBV have been available for more than two decades. 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 that the first dose should be given as soon as possible after birth.[3]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 proportion of vaccinated children (5–10%) have a poor response to vaccination, and will remain susceptible as adults to acquisition of HBV infection.:[4][5]
The vaccine is highly effective. In endemic countries with high rates of hepatitis B infection, vaccination of newborns has not only reduced the risk of infection, but has also led to marked reduction in liver cancer. This was reported in Taiwan where the implementation of a nationwide hepatitis B vaccination program in 1984 was associated with a decline in the incidence of childhood hepatocellular carcinoma.[6]
Patients with HIV appear to have inferior antibody responses to hepatitis B vaccination.This is not surprising, because some HIV-positive people have damaged immune systems: this may happen even before opportunistic infections take hold, thus justifying a diagnosis of AIDS.[7]
Type of the vaccines
The vaccine was originally prepared from plasma obtained from patients who had long-standing hepatitis B virus infection. However, currently, these are more often made using recombinant DNA technology, though plasma-derived vaccines continue to be used; the two types of vaccines are equally effective and safe.[8]
- Plasma
- Recombinant
- Yeast-derived recombinant
- Mammalian cell-derived recombinant
Vaccination recommendation
Hepatitis B vaccination recommendation in Infant and neonates include:[4]
- All infants should receive their first dose of hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by two or three doses.
Hepatitis B vaccination recommendation in adults include:[9][10]
- Any person who wants to be protected from HBV infection
- Patient with diabetes mellitus (age 60 years or older with diabetes mellitus, at the discretion of the treating clinician)
- Patient with end-stage renal disease, including patients receiving hemodialysis; HIV infection; or chronic liver disease
- Sexually active and not in a long-term, mutually monogamous relationship (e.g., more than 1 sex partner during the previous 6 months)
- Seeking evaluation or receiving treatment for a sexually transmitted infection (STI)
- A male who has sex with males
- A current or recent injection-drug user
- At occupational risk of infection through exposure to blood or blood-contaminated body fluids
- Health care worker
- Public safety worker
- Trainee in a health professional or allied health school
- Residents or staff of an institution for persons with developmental disabilities
- Sex partner or household member of a person who is chronically infected with HBV (HBsAg-positive)
- People living in correctional facilities
- All teenagers ages 18 and younger who are not fully vaccinated
- Planned travel to a country with high or intermediate prevalence of endemic HBV infection
- Hepatitis B vaccination should be administered to all unvaccinated people traveling to areas with intermediate to high prevalence of chronic hepatitis B (HBV surface antigen prevalence ≥2%)
Recommended schedule
The vaccination schedule
- Children and adults 3 intramuscular injections, the second and third doses administered 1 and 6 months
Licensed hepatitis B vaccines in the United States
Currently licensed hepatitis B vaccines in the United States:[9]|
- Single-antigen hepatitis B vaccines
- ENGERIX-B
- RECOMBIVAX HB
- Combination vaccines
- PEDIARIX: Combined hepatitis B, diphtheria, tetanus, acellular pertussis (DTaP), and inactivated poliovirus (IPV) vaccine. Cannot be administered before age 6 weeks or after age 7 years.
- TWINRIX: Combined Hepatitis A and hepatitis B vaccine. Recommended for persons aged ≥18 years who are at increased risk for both Hepatitis A virus and HBV infections.
- COMVAX: (discontinued for purchase as of December 2014): Combined hepatitis B-Haemophilus influenzae type b (Hib) conjugate vaccine. Cannot be administered before age 6 weeks or after age 71 months.
Recommended doses of hepatitis B vaccines
Interrupted Vaccination
interruption between doses of hepatitis B vaccination:[9]
- After the first dose, the second dose should be administered as soon as possible
- The second and third doses should be separated by an interval of at least 8 weeks
- Only the third dose is delayed, it should be administered as soon as possible
Contraindications
Hepatitis B vaccine is contraindicated in a person who has experienced a serious systemic or anaphylactic reaction to a prior dose of the vaccine.
References
- ↑ Mast EE, Weinbaum CM, Fiore AE, Alter MJ, Bell BP, Finelli L; et al. (2006). "A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults". MMWR Recomm Rep. 55 (RR-16): 1–33, quiz CE1-4. PMID 17159833.
- ↑ US. Preventive Services Task Force. Screening for Hepatitis B infection. (2014) https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-b-virus-infection-screening-2014?ds=1&s=hepatitis%20b Accessed on October 4th, 2016
- ↑ Ni JD, Xiong YZ, Wang XJ, Xiu LC. Does increased hepatitis B vaccination dose lead to a better immune response in HIV- infected patients than standard dose vaccination: a meta-analysis? Int J STD AIDS. 2013;24(2):117–22.
- ↑ 4.0 4.1 World Health Organization, Guidelines for the Prevention, Care, and Treatment of persons with chronic Hepatitis B Infection. (March 2015). http://apps.who.int/iris/bitstream/10665/154590/1/9789241549059_eng.pdf Accessed on October 4th, 2016
- ↑ Liu CJ, Liou JM, Chen DS, Chen P J.Natural course and treatment of dual hepatitis B virus and hepatitis C virus infections. J Formos Med Assoc Taiwan. 2005;104(11):783–91.
- ↑ Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, Liang DC, Chau WY, Chen DS (1997). "Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group". N Engl J Med. 336 (26): 1855–9. PMID 9197213.
- ↑ Pasricha N, Datta U, Chawla Y, Singh S, Arora S, Sud A, Minz R, Saikia B, Singh H, James I, Sehgal S (2006). "Immune responses in patients with HIV infection after vaccination with recombinant Hepatitis B virus vaccine". BMC Infect Dis. 6: 65. PMID 16571140.
- ↑ Szmuness W, Stevens CE, Harley EJ, Zang EA, Oleszko WR, William DC; et al. (1980). "Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States". N Engl J Med. 303 (15): 833–41. doi:10.1056/NEJM198010093031501. PMID 6997738.
- ↑ 9.0 9.1 9.2 9.3 Centers for Disease Control and Prevention. Hepatitis B (2016) http://www.cdc.gov/hepatitis/hbv/hbvfaq.htm#vaccFAQ Accessed on September 29, 2016
- ↑ Centers for Disease Control and Prevention. Infectious Diseases Related to Travel. Hepatitis B. (2015) http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/hepatitis-b#4621 Accessed on October 4th, 2016