Combined Passive and Active Immunization for Preventing Perinatal Transmission of Hepatitis B Virus Carrier State

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Abstract
Prevention of perinatal transmission of hepatitis B virus carrier state in neonates at high risk was attempted by a combined passive and active immunization. Immediately after delivery, 10 babies born to mothers who were asymptomatic carriers of hepatitis B surface antigen (HBsAg) and seropositive for hepatitis B e antigen received an i.v. injection of F(ab'')2 fragments (200 IU) derived from hepatitis B immune globulin (HBIG). On the following day, none of them revealed detectable levels of the antibody to HBsAg in their sera, and received an i.m. injection of HBIG (200 IU) which was repeated at 2 and 4 mo. of age. Vaccination with 40 .mu.g of purified, formalin-inactivated HBsAg particles was given to the 9 babies at 3 mo. and repeated at 4, 5 and 7 mo. after birth. All of them maintained detectable levels of the antibody and escaped infection throughout the first 12 mo. of their lives. The 1 baby who did not have detectable F(ab'')2 in serum for 24 h developed persistent HBs antigenemia which was noticed as early as 7 days after birth.