Preventing and treating hepatitis B infection: Immunisation is most important strategy to control hepatitis B

doi:10.1136/bmj.330.7484.197-c

BMJ 2005;330:197-198 (22 January), doi:10.1136/bmj.330.7484.197-c

Letter

Preventing and treating hepatitis B infection

Immunisation is most important strategy to control hepatitis B

The first 150 words of the full text of this article appear below.

EDITOR—The immunisation advice in the hepatitis B reviewby Aggarwal and Ranjan is potentially misleading.¹

Firstly, recommending three doses at 0, 1, and 6 months is unnecessarilylimiting; delaying the third dose can lead to lower compliance.Hepatitis B vaccine has been shown to be immunogenic when awide range of schedules is used.² Although increasing the timebetween the second and third doses leads to higher antibodyconcentrations, it seems to be the immune memory rather thanantibody concentrations that is of primary importance. A twodose schedule was approved for adolescents in the United Statesin 1999; it has also been suggested as being adequate for infants.³

Secondly, the importance of hepatitis B immune globulin is overstated.It provides comparatively little additional protection to immunisationin preventing infection in infants of HBeAg positive mothers.^4
5

Thirdly, although recommending giving vaccine to infants ofHBeAg positive mothers as . . . [Full text of this article]

Osman David Mansoor, public health physician

Public Health Consulting, 4/14 College Street, Wellington, New Zealand oz@phc.org.nz

Nick Wilson, senior lecturer

Department of Public Health Wellington, School of Medicine and Health Sciences, PO Box 7343, Wellington South 6005, New Zealand