dc.contributor.author |
Petousis-Harris, Helen |
en |
dc.contributor.author |
Reynolds, Gary |
en |
dc.contributor.author |
Ellis, Tracey |
en |
dc.contributor.author |
Nowlan, Mary |
en |
dc.date.accessioned |
2019-09-15T20:43:53Z |
en |
dc.date.issued |
2013 |
en |
dc.identifier.citation |
2013. Auckland UniServices Limited, Auckland, New Zealand. 47 pages |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/47699 |
en |
dc.description.abstract |
Hepatitis B virus (HBV) belongs to the Hepadnaviridae family and is responsible for most of the chronic hepatitis burden caused by the five known hepatitis viruses. It is estimated that around 6% of the world’s population live with chronic hepatitis B infection and approximately 30% have serologic evidence of HBV infection. The development of recombinant technologies in the early 1980s has led to affordable and effective vaccines, which are now scheduled for prevention strategies in 177 countries. The world’s first universal hepatitis B vaccination programme began in Taiwan in 1984 and long term data for the effectiveness of hepatitis B vaccination is now emerging including outcomes for liver cancer. In New Zealand (NZ) there has been a steady downward trend in the number of hepatitis B notifications which is attributable to the implementation of a universal hepatitis B vaccination programme. The highest notification rate is among Pacific People followed by Asian. The most common risk factor for acute hepatitis B infection is overseas travel and sexual contact. Recent mathematical modelling supports a reproduction number of less than one which indicates eradication is a possibility; however increased immigration is likely to provide an increasing source of new carriers. The safety of hepatitis B vaccines is well established and there are few new studies specifically investigating the safety of hepatitis B vaccines. There are no safety signals for use in pregnant women following widespread use; however the fact that there are few controlled trails in pregnant women using hepatitis B vaccine has been highlighted. Pregnancy outcomes in pregnant women exposed to hepatitis B virus (HBV) are similar to those in the unexposed population. Hepatitis B vaccine is delivered universally as part of multivalent vaccines on infant schedules and these vaccines have been rigorously evaluated for safety. Hepatitis B vaccination is highly effective with virtually complete protection in persons who seroconvert to the vaccine. Long-term protection (over 20 years) has been demonstrated despite a decrease in anti-hepatitis B surface antigen antibodies over time. Two dose schedules have been evaluated in children and adolescents and are generally found to be highly immunogenic and non-inferior to three dose schedules. Duration of immunity to a two-dose schedule in children has been so far been demonstrated out to 10 years. Flexibility in the schedule has also been shown in adults with a third dose given 11 months after the second dose and an accelerated schedule in pregnant women given within four months is immunogenic. Higher antigen doses have been demonstrated to be an effective strategy to improve seroconversion in non-responders to HBV vaccine. Boosters in the immunocompetent are not required as long as a full course has been adequately administered. However, a booster dose should be considered for immunocompromised patients, based on serological monitoring. Countries that have introduced universal vaccination against hepatitis B have experienced significant reductions in HBV prevalence and Taiwan has demonstrated a reduction in liver cancer in younger cohorts as a result of over 20 years of hepatitis B vaccination. The effectiveness of HBV vaccination in children born to HBsAg+ mothers indicates that acquisition of infection is relatively rare after post exposure prophylaxis of hepatitis B immune globulin (HBIG) and HBV vaccine and no patients have been documented to acquire infection if they have demonstrated a protective concentration of antibody. There are two hexavalent vaccines that include hepatitis B antigen for use in routine infant schedules and a range of monovalent and multivalent vaccines for use in other groups. The vaccines can be used in a variety of schedules with one and two dose options. The bivalent hepatitis A and B vaccine Twinrix® has been found to increase responses in previous non-responders. There are no indicators to suggest any changes to the current routine infant schedule are needed. The only factor that requires consideration is the adoption of a universal birth dose and an important consideration around the potential value of a universal birth dose is the performance of the current screening and neonatal immunoprophylaxis programme in NZ. Limited regional data from Auckland suggests high uptake of a birth dose in infants born to HBsAg+ve mothers however gaps have been identified. A national evaluation of the screening and neonatal programmes would be a useful strategy before considering the implementation of a universal birth dose of hepatitis B vaccine. Global practice around the use of hepatitis B vaccines is varied with respect to vaccines used and schedules. Moves to eliminate hepatitis B infection from the population have prompted recommendations for routine birth doses of vaccine and greater efforts to achieve higher rates of vaccination of both high risk adults as well as non-high risk adults. This report is one of a series of reports covering the most recent four years of literature for 18 different vaccine preventable diseases. The dates for publication are between 2009 and 2012 as per the brief. This is not a systematic review or a critique of the literature. The choice of articles reviewed is based on the purposeful selection of recent reviews and studies that may best inform policy discussions around hepatitis B vaccines for NZ. |
en |
dc.description.uri |
http://www.immune.org.nz/2012-antigen-review-new-zealand-national-immunisation-schedule-hepatitis-b |
en |
dc.publisher |
Auckland UniServices Limited |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
2012 Antigen Review for the New Zealand National Immunisation schedule : Hepatitis B |
en |
dc.type |
Report |
en |
dc.rights.holder |
Copyright: Immunisation Advisory Centre |
en |
pubs.author-url |
http://ebooks.fmhs.auckland.ac.nz/2012-antigen-review-hepatitisb/ |
en |
pubs.commissioning-body |
New Zealand Ministry of Health |
en |
pubs.place-of-publication |
Auckland, New Zealand |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Commissioned Report |
en |
pubs.elements-id |
424601 |
en |
dc.relation.isnodouble |
1385425 |
* |
dc.relation.isnodouble |
1385427 |
* |
dc.relation.isnodouble |
1385420 |
* |
dc.relation.isnodouble |
1385423 |
* |
dc.relation.isnodouble |
1385417 |
* |
dc.relation.isnodouble |
1385422 |
* |
dc.relation.isnodouble |
1385426 |
* |
dc.relation.isnodouble |
1385433 |
* |
dc.relation.isnodouble |
1385435 |
* |
dc.relation.isnodouble |
1385437 |
* |
dc.relation.isnodouble |
1385429 |
* |
dc.relation.isnodouble |
1385431 |
* |
dc.relation.isnodouble |
1385428 |
* |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
Population Health |
en |
pubs.org-id |
Gen.Practice& Primary Hlthcare |
en |
pubs.record-created-at-source-date |
2014-01-23 |
en |