Hepatitis B vaccine

Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. The vaccine contains one of the viral envelope proteins, hepatitis B surface antigen (HBsAg). After a course of three (3) vaccine injections, an immune system antibody to HBsAg is established in the bloodstream. The antibody is known as anti-HBsAg. This antibody and immune system memory then provide immunity to hepatitis B infection.^[1]

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History

The vaccine was originally prepared from plasma obtained from patients who had long-standing hepatitis B infections. However, vaccines currently used in the United States are made using recombinant DNA technology.^[2] The two types of vaccines are considered equally effective. In the United States, two of the newer recombinant vaccines are Engerix-B (made by GlaxoSmithKline),^[3] and Recombivax HB^[4] (made by Merck). The recombinant vaccines consist of proteins produced in modified yeast cultures. Unlike plasma-derived vaccines, these recombinant vaccines are not produced using human cell lines or human tissue material.^[3][4]

Infection with hepatitis B may lead to hepatocellular carcinoma, a type of liver cancer. Therefore, the hepatitis-B vaccines are cancer-preventing vaccines. According to the Centers for Disease Control and Prevention (CDC), the hepatitis B vaccine was the first anti-cancer vaccine.^[5]

Recommended populations

Babies born to mothers with active hepatitis B infections are recommended to receive treatment reducing the risk of mother-to-child transmission of the hepatitis B infection. As soon as possible and within 48 hours of birth, newborns are vaccinated with hepatitis B surface antigen (HBsAg) and injected with hepatitis B immune globulin (HBIG).^[6]

Many countries now routinely vaccinate infants against hepatitis B. In countries with high rates of hepatitis B infection, vaccination of newborns has not only reduced the risk of infection, but has also led to marked reduction in liver cancer. This was reported in Taiwan where the implementation of a nationwide hepatitis B vaccination program in 1984 was associated with a decline in the incidence of childhood hepatocellular carcinoma.^[7]

In many areas, vaccination against hepatitis B is also required for all health-care workers.^{[citation needed]} Some college campus housing units now require proof of vaccination as a prerequisite.^{[citation needed]}

At least one study suggests that hepatitis B vaccination is less effective in patients with HIV.^[8]

References

1. ^ Centers for Disease Control, USA (December 8, 2006). Hepatitis B Vaccine: Fact Sheet.
2. ^ Immunization Action Coalition (September 2007). Hepatitis A & B Vaccines (Be sure your patient gets the correct dose!).
3. ^ ^{a b} GalxoSmithKline (December 2006). Engerix-B® Prescribing Information.
4. ^ ^{a b} Merck (October 2006). Recombivax HB® Hepatitis B Vaccine (Recombinant).
5. ^ Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (February 23, 1999). "http://frwebgate6.access.gpo.gov/cgi-bin/waisgate.cgi?WAISdocID=364662410388+1+0+0&WAISaction=retrieve" 64 (35).
6. ^ (December 23, 2005) "A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the ACIP, Part 1: Immunization of Infants, Children and Adolescents". MMWR 54 (RR-16).
7. ^ Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, Liang DC, Chau WY, Chen DS (1997). "Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group". N Engl J Med 336 (26): 1855-9. PMID 9197213.
8. ^ Pasricha N, Datta U, Chawla Y, Singh S, Arora S, Sud A, Minz R, Saikia B, Singh H, James I, Sehgal S (2006). "Immune responses in patients with HIV infection after vaccination with recombinant Hepatitis B virus vaccine". BMC Infect Dis 6: 65. PMID 16571140.

See also

• Twinrix