Prevention

Vaccination | Other Preventative Measures

Vaccination

Since 1982, over one billion doses of hepatitis B vaccine have been used worldwide.
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There are currently two vaccines that are used to prevent Hepatitis B infection - Recombivax HB (Merck) and Engerix-B (GlaxoSmithKline). Dual protection using the Twinrix vaccine (GlaxoSmithKline) is also avaialble to prevent both Hepatitis A and B. These vaccines have the potential to prevent serious consequences such as cirrhosis and liver cancer (hepatocellular carcinoma). The Hepatitis B vaccine was the first vaccine to prevent cancer. All children should get the first dose of the Hepatitis B vaccine when they are born and should have completed the 3 shot series by 18 months. Twinrix is currently only licensed for those 18 years and over.

*Heptavax was the first Hepatitis B vaccine but is not replaced by Recombivax HB and Engerix B.

Since 1992, universal childhood vaccination against HBV infectionhas been monitored and control programs have commenced in hopes of eradicating the virus. The goal was integrating vaccination into national immunization programs in countries with rates of chronic infection over 8%. This was adopted by 135 countries. Unfortunately, HBV is still present, concentrated in the high-risk populations. These programs have failed because of two main reasons: 1) it is difficult to identify and access the patients that are at high risk 2) noncompliance with the vaccination regimens once a patient starts the treatment. Even in populations that know they are at high risk such as health care workers, their compliance is only about 50%.

*Courtesy of WHO.gov: http://www.who.int/csr/disease/hepatitis/HepatitisB_whocdscsrlyo2002_2.pdf

There is now much evidence that the Hepatitis vaccine is very effective. It has been shown that 95% of patients develop antibody against HBV surface antigen, and HBV infection is only 3.2% in vaccinated individuals vs. 25.6% in recipients of placebo.

*Courtesy of Mark Kane Lecture, International Health 2008 taught by Professor Paul Wise

The efficacy of the vaccines can depend on age. In adults older than 40, this percentage drops to 84%. Only 75% of those older than 60 years old developed antibodies. Other factors affecting the efficacy of vaccines include smoking, obesity, and immune suppression.

Other Preventative Measures:

• If you are having sex with an infected partner, use latex condoms every time. The efficacy of condoms is unknown but their use has been known to reduce transmission of other parenterally transmitted viruses such as HIV.
• Pregnant women should get a Hepatitis B test. Babies born with HBV should receive HBIG (Hepatitis B ImmunoGlobulin) within 12 hours of birth. In addition, Hepatitis B vaccines are the only vaccines that can be administered at birth.
• Do NOT shoot drugs. Do NOT share needles as the virus is transmitted through the blood.
• Do not share personal care products such as razors or toothbrushes which may have blood on them
• When getting a tatoo or body piercing, make sure that the artist and/or piercer is using proper sanitation techniques. He/she should not be using contaminated needles and instruments
• If you have or have had Hepatitis B, it is best not to donate your organs, blood, or other bodily tissue.

Pegasys Picture courtesy of The Biotech Weblog http://www.biotech-weblog.com/50226711/poches_pegylated_interferon_alfa2a_cures_hepatitis_c.php

CDC hepatitis B Fact Sheet: http://www.cdc.gov/ncidod/diseases/hepatitis/b/fact.htm

Richman, Douglas D., Richard J. Whitley, and Frederick G. Hayden, eds. Clinical Virology. 2nd ed. Washington, DC: ASm P, 2002. 642-4.