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J Antimicrob Chemother. 2015 Feb;70(2):396-404. doi: 10.1093/jac/dku404. Epub 2014 Oct 31.

Hepatitis B vaccine alone or with hepatitis B immunoglobulin in neonates of HBsAg+/HBeAg- mothers: a systematic review and meta-analysis.

Author information

1
2nd Department of Pediatrics, National Kapodistrian University of Athens, School of Medicine, and P. & A. Kyriakou Children's Hospital, Athens, Greece.
2
3rd Department of Pediatrics, 'Attikon' General University Hospital, Athens, Greece.
3
Alfa Institute of Biomedical Sciences, Athens, Greece.
4
Alfa Institute of Biomedical Sciences, Athens, Greece Department of Medicine, Tufts University School of Medicine, Boston, MA, USA m.falagas@aibs.gr.

Abstract

OBJECTIVES:

The cost-effectiveness of augmenting immunization against hepatitis B infection with hepatitis B immunoglobulin (HBIG) remains controversial, particularly for the subpopulation of babies of HBsAg+/HBeAg- mothers that are considered as low-infective. We aimed to evaluate the effectiveness of vaccine alone compared with vaccine plus HBIG for the immunization of babies of HBsAg+/HBeAg- mothers.

METHODS:

We searched PubMed, Scopus and Cochrane Central Register of Controlled Trials databases to identify studies comparing the effectiveness of combined immunization (vaccine plus HBIG) with vaccine alone in neonates of HBsAg+/HBeAg- mothers. A systematic review and meta-analysis of eligible studies was performed.

RESULTS:

A total of nine eligible studies were identified (four randomized controlled trials). No difference was found regarding the primary outcome of our meta-analysis, namely occurrence of hepatitis B infection, between neonates who received vaccine only, compared with those who received both vaccine and HBIG (four studies, 3426 patients, OR=0.82, 95% CI=0.41-1.64). This finding was consistent with regards to seroprotection rate (four studies, 1323 patients, OR=1.24, 95% CI=0.97-1.58). Safety data were not reported in the included studies.

CONCLUSIONS:

The available limited published evidence suggests that vaccine alone seems to be equally effective to the combination of HBIG and hepatitis B vaccine for neonates of HBsAg+/HBeAg- mothers in preventing infection. Further studies are needed in order to clarify the potential benefit of combined immunization to this specific subgroup of patients.

KEYWORDS:

HBV; hepatitis B virus; immunization

PMID:
25362571
DOI:
10.1093/jac/dku404
[Indexed for MEDLINE]

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