Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy
Italy was one of the first industrialized countries to implement a program of routine vaccination against hepatitis B virus (HBV) infection. However, currently, no HBV vaccine is administered at birth if the screened mother is HBsAg negative, whilst babies born to HBsAg positive mothers are given va...
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| Format: | Article |
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MDPI AG
2021-07-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/9/7/801 |
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| author | Michele Pinon Laura Giugliano Emanuele Nicastro Omar Kakaa Alessandra Coscia Caterina Carbonara Lorenzo D’Antiga Pier Luigi Calvo |
| author_facet | Michele Pinon Laura Giugliano Emanuele Nicastro Omar Kakaa Alessandra Coscia Caterina Carbonara Lorenzo D’Antiga Pier Luigi Calvo |
| author_sort | Michele Pinon |
| collection | DOAJ |
| description | Italy was one of the first industrialized countries to implement a program of routine vaccination against hepatitis B virus (HBV) infection. However, currently, no HBV vaccine is administered at birth if the screened mother is HBsAg negative, whilst babies born to HBsAg positive mothers are given vaccine and hepatitis B immunoglobulin, within 12–24 post-delivery hours. A single center retrospective analysis of policies and practices to prevent mother-to-child transmission of HBV was carried out, to evaluate their adherence to HBV care guidelines. Paired maternal-infant medical records for consecutive live births, between January 2015 and December 2019, were reviewed at the AOU Città della Salute e Scienza di Torino, where a total of 235/35,506 babies (0.7%) were born to HBsAg positive mothers. Markers of active viral replication, i.e., HBV DNA level and/or HBeAg, were reported in only 66/235 (28%) of the mothers’ medical records. All newborns had immunoprophylaxis at birth: 61% at <12 h, 31% between 12 and 24 h, 7% between 24 and 36 h and 1% at >36 h. In 2019, two cases of vertical HBV transmission occurred, despite timely immunoprophylaxis, as their mothers’ viral load was detected too late for antiviral prophylaxis. Missed early identification of pregnant women with high viremia levels or late vaccinations may contribute to perinatal HBV infection. Immunoprophylaxis should be given to babies born to HBsAg positive mothers at the latest within 12 h. In Italy, policies aimed at achieving the WHO 2030 goal of eliminating viral hepatitis should be further implemented. |
| first_indexed | 2024-03-10T09:21:01Z |
| format | Article |
| id | doaj.art-b07870e4d03b4fe998e76c1f4e28f580 |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-10T09:21:01Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-b07870e4d03b4fe998e76c1f4e28f5802023-11-22T05:13:15ZengMDPI AGVaccines2076-393X2021-07-019780110.3390/vaccines9070801Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in ItalyMichele Pinon0Laura Giugliano1Emanuele Nicastro2Omar Kakaa3Alessandra Coscia4Caterina Carbonara5Lorenzo D’Antiga6Pier Luigi Calvo7Pediatric Gastroenterology Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, ItalyPediatric Gastroenterology Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, ItalyPaediatric Hepatology, Gastroenterology and Transplantation, ASST Ospedale Papa Giovanni XXIII, 24127 Bergamo, ItalyDepartment of Pediatrics and Public Health Sciences, University of Turin, 10126 Turin, ItalyNeonatology Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, ItalyNeonatology Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, ItalyPaediatric Hepatology, Gastroenterology and Transplantation, ASST Ospedale Papa Giovanni XXIII, 24127 Bergamo, ItalyPediatric Gastroenterology Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, ItalyItaly was one of the first industrialized countries to implement a program of routine vaccination against hepatitis B virus (HBV) infection. However, currently, no HBV vaccine is administered at birth if the screened mother is HBsAg negative, whilst babies born to HBsAg positive mothers are given vaccine and hepatitis B immunoglobulin, within 12–24 post-delivery hours. A single center retrospective analysis of policies and practices to prevent mother-to-child transmission of HBV was carried out, to evaluate their adherence to HBV care guidelines. Paired maternal-infant medical records for consecutive live births, between January 2015 and December 2019, were reviewed at the AOU Città della Salute e Scienza di Torino, where a total of 235/35,506 babies (0.7%) were born to HBsAg positive mothers. Markers of active viral replication, i.e., HBV DNA level and/or HBeAg, were reported in only 66/235 (28%) of the mothers’ medical records. All newborns had immunoprophylaxis at birth: 61% at <12 h, 31% between 12 and 24 h, 7% between 24 and 36 h and 1% at >36 h. In 2019, two cases of vertical HBV transmission occurred, despite timely immunoprophylaxis, as their mothers’ viral load was detected too late for antiviral prophylaxis. Missed early identification of pregnant women with high viremia levels or late vaccinations may contribute to perinatal HBV infection. Immunoprophylaxis should be given to babies born to HBsAg positive mothers at the latest within 12 h. In Italy, policies aimed at achieving the WHO 2030 goal of eliminating viral hepatitis should be further implemented.https://www.mdpi.com/2076-393X/9/7/801hepatitis B virusvertical transmissiontimely vaccinationimmunoprophylaxisprevention strategies |
| spellingShingle | Michele Pinon Laura Giugliano Emanuele Nicastro Omar Kakaa Alessandra Coscia Caterina Carbonara Lorenzo D’Antiga Pier Luigi Calvo Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy Vaccines hepatitis B virus vertical transmission timely vaccination immunoprophylaxis prevention strategies |
| title | Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy |
| title_full | Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy |
| title_fullStr | Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy |
| title_full_unstemmed | Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy |
| title_short | Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy |
| title_sort | timely birth dose vaccine to prevent vertical transmission of hepatitis b a single center experience on the road to the who elimination goals in italy |
| topic | hepatitis B virus vertical transmission timely vaccination immunoprophylaxis prevention strategies |
| url | https://www.mdpi.com/2076-393X/9/7/801 |
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