EFFICACY OF HBIG AND VACCINE IN INFANTS OF HBSAG POSITIVE CARRIER MOTHERS

Background-Neonates born to HBsAg positive mothers are at high risk of hepatitis B virus (HBV) infection. The aim of this study was to evaluate the efficacy of hepatitis B immunoglobulin and HBV vaccine in these infants. Methods-From September 1998 to September 2000, 103 infants born to HBsAg and HBeAg positive mothers were followed. All infants received HBIG and the first dose of vaccine at birth and the second and third doses of vaccine at 1.5 and 9 months of age, respectively. Post-vaccination tests were performed on 93 infants at 12 to15 months of age. Data were then analyzed by the Chi-square and Fisher exact tests. Results-Nine mothers (9.7%) were HBeAg positive. Fifty-nine (63.4%) infants were anti- HBs positive. The differences between the rate of anti-HBs were not significant in either sex (p=0.64). An antibody titer of more than 100 IU/mL was defined as responder and seen in 41 (48.8%) infants who were born to HBsAg-positive mothers, significantly higher than infants of HbeAg positive mothers (p=0.0062). HBsAg was positive in 3 (3.6%) infants born to HBeAg negative mothers, significantly lower than the incidence of HBsAg positivity (33.3%) in infants born to HBeAg positive mothers (p=0.011). Seventeen infants (18.3%) were poor responders and 34 (36.6%) were non-responders. Conclusion-In this study children who were poor or non-responders to HBV vaccination in these groups of children are relatively high and additional doses of the vaccine were required for satisfactory immunization. Some of these infants may become chronic carriers. Postvaccination testing is necessary.