10 4 .. ..

2529 3-9

Immunoprophylaxis for virus B

Wattana Sukeepaisarncharoen
Gastroenterology unit, Department of Medicine
Faculty of Medicine, Khon Kaen University
/
/
In high hepatitis B carriers country, many people who contact are susceptibility. We use
hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) or immunoglobulin for active and passive
immunization respectively. Vaccination is recommended pre exposure. HBIG and vaccine are used for post
exposure such as neonatal, percutaneous, acute sexual and house hold contact with virus B.
Immunoprophylaxis are protectiveness depend on immunization at the proper time.
/
/

(HBIG) (IG)
high risk
,

 10 4
.. .. 2529

/

2
/
Active immunization
/
Passive immunization
immunoglobulin

HBIG [Hepatitis B immunoglobulin]

/
IG titer antiHBs

antiHBs IG 10,000
20,000 75% 2
HBIG antiHBs
1:10,000 RIA 180
international unit/cc
IG, HBIG
/
0.06 cc/kg/dose adult = 5 cc

HBsAg 3

1 plasma derived vaccine

(IG)
/
IG .. 1940 1 IG


.. 1977
IG antiHBS
1:100 RIA

Prevaccination on serologic screening for

susceptible 3
/
vaccine
/
1.
/
2.

/
3. prevalence
/
3


prevalence

HBV screening
cost effectiveness community
prevalence screening cost
effectiveness screen antiHBc antiHBs
antiHBc
anti
HBs
2% screen
anti HBs > 10
SRU RIA

Post vaccination serology

/

antiHBs
90% antiHBs
,

HBsAg antiHBs
/


antiHBs
titer
screen titer antiHBs

 10 4
.. .. 2529

HBIG IG

2
/
1. Pre exposue prophylaxis
/
2. Post exposure prophylaxis
Pre exposure prophylaxis
/

HBIG IG

/
1.
, , ,
, ,

/
2.

( 20%)


/
3.

60 - 70 %
/
4.
-
-
/
5.

/
6.

/
7.
/
8.

6
HBIG IG 0.06 cc/k
/
9.
HBsAg,


Post exposure prophylaxis
:


/
1.
/
2.
/
3.
/
4.
Perinatal transmission
/
HBsAg
70% HBsAg
HBeAG 90 % HBsAg
antiHBe 20%

HBIG
85 90% 1, 9-14 HBIG dose
70% vaccine 75% HBIG 1
dose 50% 15 Center of

Disease Control 3
/
1.
/
1.1
/

/
1.2 , ,
/

/

/
1.3
/

/
1.4
/
1.5
/
1.6
/
1.7
/

/
1.8
/
1.9
/

/
1.10 venereal disease
/

/
2. HBsAg
HBeAg antiHBe HBIG

/
3. HBIGS 0.5 cc 6-12
48 0.5 cc (10
ug) HBIG
dose 7
/
4. 6 HBsAg

/
4.1 HBsAg

/
4.2 HBsAg 0.5 cc
/
5. 12, 15 HBsAg,
antiHBc, antiHBs antiHBs
antiHBc

 10 4
.. .. 2529

Sexual contact acute infection

/
HBIG 75% 16
90%

/
1. 1 HBIG 1 does
14
/
2. 1
3-6 HBIG dose 2 dose 3
x 3 dose HBIG
/
3. HBIG 1

x 3 dose
/
4. HBIG

Houshold contacts of person with acute infection

/



HBIG

1. Krugman S. Perspective on viral hepatitis:Prophylaxis of hepatitis B

2. Seef LB, Hoofnagle JH. Immunoprophylaxis of viral hepatitis. Gastroenterology 1979; 77:161-82
3. Center for disease control. Recommendation for protection against viral hepatitis. Ann Int Med
1985:103:319-402
4. Dienstag J-L, Steven CE, Bhan AK, Szmuness W. Hepatitis B vaccine administered to chronic
carrier of hepatitis B surface antigen. Am Inter. Med 1982; 96:575-9
5. Szmuness W, steven CE, Oleszko WR, Goodman A Passive-active immunization against
hepatitis B immunogenicity studies in adult Americans. Lancet 1981; 1:575-7
6. Steven CE, Neurath RA, Beasley RP, Szmuness W. HBeAg and anti-HBe detection by radio
immunoassay:Correlation with vertical transmission of hepatitis B virus in Taiwan. J Med virol
1979; 3:237-41
7. Beasley RP, Trepo C, Steven CE, Szmuness W. The e antigen and vertical transmission of
hepatitis B surface antigen. Am J. Epidermol 1977; 105:94-8
8. Pongpipat D, Suvatte V, Assateerawatts A. Perinatal transmission of hepatitis B virus in
Thailand. Asian Pacific of Allerg Immunogenicity 1985; 3:191-3
9. Seef LB, Koff RS. Passive and active immunoprophylaxis of hepatitis B Gastroenterology 1984;
86:958-81
10. Pongpipat D, Suratte V, Assateerawatts A. Hepatitis B immun O glogulin (HBIG); Efficacy in the
interruption of vertical transmission of hepatitis B virus (HBV) carrier state. J Med Ass Thailand.
1983; 66:49-53

11. Pongpipat D, Suvatte V, Assateerawatts A. Efficacy of hepatitis B immunoglobulin and hepatitis B

vaccine in prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carrier of
HBsAg and HBeAg. Asian Pacific J Allerg Immun 1986; 4:33-36
12. Pongpipat D. Prevention of hepatitis B virus infection (Editorial) Asian Pacific J Allerg Immun 1986; 4:1-3
13. Steven CE, Toy PT, Tong MJ, et al. Perinatal hepatitis B virus transmission in the united state:prevention
by passive-active immunization. JAMA 1985; 253:1740-5
14. Beasley RP, Hwang LY, Lee GC. et al. Prevention of perinatally transmitted hepatitis B virus infection with
hepatitis B immune glogbulin and hepatitis B vaccine. Lancet 1983; 2:1099-102
15. Beasley RP, Hwang LY, Steven CE, et al. Efficacy of hepatitis B immunoglobulin for prevention of
perinatal transmission of hepatitis B virus carrier state; final report of a randomized double - blind placebo controlled trial. Hepatology 1983; 3:135-41
16. Redeker AG. Mosley JW, Gccke DJ, Makee AP, Pollack W. Hepatitis B immuneglobulin as a prophylactic
measure for spouses exposed to acute type B hepatitis. N Engl J. Med 1975; 293:1055-9