HBV infection can be prevented by avoiding transmission from infected people and by inducing immunity in unexposed or exposed people.
Immunoglobulins are antibody preparations that are produced from donated blood. Hepatitis B immunoglobulin (HBIG), given by injection, can provide "instant immunity" against HBV. This is used to protect non-immune people who have been exposed to HBV (see "Cause"). The immunoglobulin will not be effective if given too late after exposure when the virus has already established an infection. Immunoglobulin and a first dose of the hepatitis B vaccine can be given simultaneously at different injection sites.
Hepatitis B vaccines are safe and highly effective in preventing hepatitis B infection. In South Africa, vaccination against hepatitis B has been part of the routine childhood Expanded Programme on Immunisation (EPI) since 1995. The vaccine is given to infants at the ages of six, 10 and 14 weeks, along with the oral polio vaccine and "DPT" vaccine.
Up until 1995, hepatitis B vaccine was only given to people in high risk groups, particularly health care workers. Children and adults born before 1995 will probably not have been vaccinated against hepatitis B.
It is advisable for certain high risk groups to be vaccinated against HBV. These include:
- All infants through the EPI
- Catch-up vaccination for all infants and adolescents not previously vaccinated
- Young people who are homosexually or heterosexually active
- Spouse or sex partner(s) of an HBV infected person
- Family/household members of an HBV carrier
- High risk occupations e.g. health care and laboratory workers, public safety officers, morticians
- Intravenous drug users
- Patients on haemodialysis or in oncology units
- Patients receiving frequent blood or blood product transfusions
- Personnel of and residents in institutions e.g. correctional services, institutions/schools for the mentally handicapped and elderly
- HIV and HCV infected individuals
In older children and adults, the vaccine is given in three doses, usually over six months. It is important that three doses of vaccine be given, with at least one month spacing between them, in order for good immunity to be achieved.
Preventing mother to baby transmission
To help prevent transmission from mother to infant, all pregnant women should have a blood test for HBsAg. If the mother is HBsAg-positive, she should be referred to a specialist
Her baby should be given prophylactic treatment (HBIG and the first dose of HBV vaccine at different injection sites) as soon as possible, preferably within 12 hours after birth.
This will significantly decrease the risk of transmitting the virus to the infant.
Additional doses of the HBV vaccine can be administered with the regular childhood immunisations at six, 10 and 14 weeks, or, alternatively at one and six months of age.
Revised and reviewed by Dr Karin Richter, MMed Path (Medical Virology), FC Path(SA) Viro, Dip HIV Man (SA), Dip Obst (SA), MBChB , Clinical Virologist, Senior Lecturer, Department of Medical Virology, University of Pretoria, Faculty of Health Sciences, and Consultant Pathologist, Tshwane Academic Division, National Health Laboratory Services (NHLS) February 2015.
Previously reviewed by Dr Eftyhia Vardas BSc (Hons), MBBCh, DTM&H, DPH, FC Path (Virol), MMed (Virol), Clinical Virologist, Director HIV AIDS Vaccine Division, Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand.