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

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.

• Authors: Maria Machaira, Vassiliki Papaevangelou, Evridiki K Vouloumanou, Giannoula S Tansarli, Matthew E Falagas
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 70 Issue 2 Pg. 396-404 (Feb 2015) ISSN: 1460-2091 [Electronic] England
• PMID: 25362571 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: [email protected].

Chemical References

• Hepatitis B Surface Antigens
• Hepatitis B Vaccines
• Immunoglobulins
• hepatitis B hyperimmune globulin

Topics

• Hepatitis B (epidemiology, prevention & control, transmission)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B Vaccines (immunology)
• Humans
• Immunoglobulins (blood)
• Infant
• Infant, Newborn
• Infectious Disease Transmission, Vertical (prevention & control, statistics & numerical data)
• Odds Ratio
• Patient Outcome Assessment