Improved Prevention of Perinatal hepatitis B transmission

Dr. Rifaat Safadi

Hepatitis B virus (HBV) is a double-stranded DNA virus includes hepatitis B surface antigen (HBsAg), hepatitis B core antigen and the viral DNA. Current HBV vaccine protects most recipients against newly acquired infection, but protection of infants from infected mothers is incomplete. Prevention of this residual rate of transmissions is crucial for the overall success of the HBV vaccination, because the infected babies become virtually chronic carriers with a high risk of cirrhosis and liver cancer later in life. Furthermore, escape mutants may be selected which may in the worst case be transmissible even to successfully vaccinated persons. Trials with preS1-containing vaccines showed a superior immunogenicity but were not designed for protection against HBV exposure. In the proposed study we will: (1) determine the prevalence of HBV infection in pregnant women in East-Jerusalem and Qatar, by screening for anti-HBc antibodies (2) characterise their state of HBV infection including data on anti-HBs, HBsAg, HBeAg, and viremia (3) determine vaccination failure rate by following vaccinated children for at least one year, tested them for HBsAg, HBV DNA, anti-HBc, anti-HBs and if positive for anti-HBc for further HBV markers (4) compare the efficacy of conventional vaccine to newly  Pre-S1/ Pre-S2 vaccine (more immunogenic).This study could also focus on the lymphocyte alterations in fibrosis among pregnant women which might focus on the therapeutic approach of hepatic fibrosis.