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AJP Rep 2015; 05(01): e67-e72
DOI: 10.1055/s-0035-1547329
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hepatitis B Postexposure Prophylaxis in Preterm and Low-Birth-Weight Infants

Markus Waitz
1   Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, University of Ulm, Germany
,
Reinhard Hopfner
1   Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, University of Ulm, Germany
,
Helmut D. Hummler
1   Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, University of Ulm, Germany
,
U. Heininger
2   Department of Pediatric Infectious Diseases and Vaccinology, University Children's Hospital Basel, University of Basel, Switzerland
› Author Affiliations
Further Information

Publication History

22 September 2014

30 December 2014

Publication Date:
04 March 2015 (online)

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Abstract

Objective Recommendations for immunoprophylaxis in low-birth-weight (LBW) infants born to hepatitis B surface antigen (HBsAg)-positive mothers vary. We successfully immunized an HBsAg-exposed infant (birth weight: 400 g) and performed a literature review on the outcome of postexposure immunoprophylaxis in HBsAg-exposed preterm and LBW infants.

Methods By use of PubMed we identified articles relevant to the topic. Studies were included if the intended vaccine schedule was completed and follow-up data were reported.

Results Antibody response was reported in 31 LBW infants (birth weight < 2,500 g) and 49 infants with gestational age of < 38 weeks. Low anti-HBs antibody levels (< 100 IU/L) were found in 9 (29%) of the 31 LBW infants. Overall, 2 of 20 (10%) preterm infants and 2 of 17 (12%) LBW were HBsAg-positive on follow-up. In one study, none of the 26 exposed very LBW infants became infected.

Conclusion Due to heterogeneity in immunization schedules, lack of information on transmission rates, and the small number of included subjects, no firm conclusions can be drawn regarding the optimal postexposure prophylaxis in LBW infants. We propose that active and passive immunization at birth should be completed by three further active doses (0–1–2–12 month schedule) until further prospective studies are available.

Keywords

immunization - HBsAg - preterm neonate - postexposure
 

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