Objective To study the effects of HBeAg in new born infants on the response to anti-hepatitis B immunoglobulin combined with hepatitis B vaccination.Methods Two hundred and eight infants who were born during January 2008 to January 2011 in the Department of Obstetrics in Second Affiliated Hospital of Southeast University,including 120 serum HBeAg positive infants without intrauterine infection,and 88 HBeAg negative infants as control group were recruited in the study.Infants in both groups were vaccinated with genetically engineered hepatitis B vaccine (CHO cell) 20 μg according to a standard vaccination regimen (i.e.0,1,6) and 200 IU doses of hepatitis B immunoglobulin immediately after birth and at day 15 respectively.Hepatitis B virus (HBV) serological markers and HBV DNA were measured at birth prior to immunization.HBsAg,HBeAgand hepatitis B surface antibody (anti-HBs) were detected at 1,7,and 12 months after birth to evaluate the effects of immune response.The date were analyzed by the chi-square test and groups were analyzed by t test.Results No statistical significances of anti-HBs were observed between the serum HBeAg positive group and the serum HBeAg negative group at the 1st,7th and the 12th month of birth (t=1.285,0.563 and-0.971,respectively; all P＞0.05).The anti-HBs titers in both groups at 1 month were higher than at birth (P＜0.05).At 7 months after birth,the anti-HBs titers in both groups were even higher than those at 1 month.At 12 months after birth,the anti-HBs titers in both groups were lower than those at 7 months,but still higher than those at 1 month(F=34.3959 and 64.908,respectively; both P＜0.01).Infants who were born with positive serum HBeAg were further divided into two subgroups according to the HBeAg titers,using the median HBeAg titer (47.495 S/CO) as the cut off point.Between the two subgroups,there were also no significant differences of anti-HBs at 1 month,7 months and 12 months (all P＞0.05).The HBeAg titers in HBeAg positive infants decreased gradually after birth.At 7 months,only 3 infants remained HBeAg positive.At 12 months,HBeAg turned negative in all of the 120 infants who were previously HBeAg positive,and no anti-HBe positivity were detected.Conclusion The production of anti-HBs after combined immunization with anti-hepatitis B immunoglobulin and hepatitis B vaccine in infants is independent of HBeAg serology at birth.

OBJECTIVETo compare the various combined immunization schemes available for treatment of babies born to mothers with high-load hepatitis B virus (HBV) infection.

METHODSA total of 118 mothers with HBV infection status of hepatitis B surface antigen-positive (HBsAg+), hepatitis B e antigen-positive (HBeAg+) and HBV DNA load of more than 1.0 * 61og10 IU/mL were included in the study. All of the participants' babies received the main-passive immunization therapy according to the wishes of their families. For analysis,the infants were grouped according to the various dosages of the vaccine program (group A: hepatitis B immunoglobulin (HBIG) 200 IU and HBVac 20 mug intramuscular;group B:HBIG 200 IU and HBVac 10 mug intramuscular; group C HBIG 100 IU and HBVac 20 mug intramuscular injection) and times, and followed-up to 7 months of age.All results were statistically analyzed using SPSS software.

RESULTSAll of the infants produced anti-HBs after vaccination.After the HBIG injection schedule was completed in January, the mean concentrations of anti-HBs in groups A, B, and C were 263.56 ± 50.98,231.06 ± 74.07, and 99.23 ± 29.82 mIU/mL respectively;the concentrations were significantly different between groups A and C, and between groups B and C (P < 0.001). In July, the titers of anti-HBs in groups A, B, and C were 788.10 ± 281.96,428.39 ± 347.48, and 708.44 ± 315.69 mIU/mL respectively; the concentrations were significantly different between groups A and B, and between groups B and C (P < 0.05).

CONCLUSIONAdminisWation of the hepatitis B vaccine combined with HBIG at birth can achieve immune protection for babies born to highly viremic mothers. In January, the HBIG dosage of 200 IU was more reliable than 100 IU. The hepatitis B 20 tg dose vaccine was safe and effective.

Hepatitis B ; Hepatitis B Antibodies ; Hepatitis B Vaccines ; Hepatitis B e Antigens ; Hepatitis B virus ; Humans ; Immunization ; Immunoglobulins ; Infant ; Mothers ; Serologic Tests ; Vaccines, Combined ; Viral Load