Wzw (wirusowe zapalenie wątroby)
Zapobieganie i profilaktyka
Wirusowe zapalenie wątroby (WZW) stanowi istotne wyzwanie zdrowia publicznego, prowadząc do poważnych powikłań, takich jak marskość, niewydolność wątroby i rak wątrobowokomórkowy. Profilaktyka opiera się głównie na szczepieniach przeciwko WZW typu A i B, które wykazują wysoką skuteczność (94-100%) i zapewniają długotrwałą ochronę – szczepionka przeciwko WZW typu A podawana jest w dwóch dawkach w odstępie 6-12 miesięcy, natomiast przeciwko WZW typu B w standardowym schemacie trzech dawek w ciągu 6 miesięcy, z nową opcją Heplisav-B (2 dawki). Szczepienia są szczególnie zalecane dla noworodków, dzieci, osób z grup ryzyka (m.in. osoby z przewlekłymi chorobami wątroby, HIV, stosujące narkotyki dożylnie, mężczyźni mający kontakty seksualne z mężczyznami) oraz pracowników ochrony zdrowia. W przypadku ekspozycji na WZW typu A lub B, profilaktyka poekspozycyjna (PEP) obejmuje podanie immunoglobulin i/lub szczepionek w określonych ramach czasowych (do 2 tygodni dla WZW A, do 72 godzin dla WZW B), co znacząco zmniejsza ryzyko zakażenia.
- Profilaktyka wirusowego zapalenia wątroby (WZW)
- Szczepienia jako podstawowa metoda profilaktyki
- Profilaktyka WZW typu C
- Profilaktyka okołoporodowa WZW
- Profilaktyka poekspozycyjna
- Profilaktyka reaktywacji WZW u osób z immunosupresją
- Ogólne środki zapobiegawcze
- Programy profilaktyki WZW na poziomie krajowym i globalnym
- Wnioski i przyszłe kierunki działań
- Kolejne rozdziały
Profilaktyka wirusowego zapalenia wątroby (WZW)
Wirusowe zapalenie wątroby (WZW) jest poważnym problemem zdrowia publicznego na całym świecie, dotykającym miliony ludzi i prowadzącym do poważnych powikłań, w tym niewydolności wątroby, marskości i raka wątrobowokomórkowego. Szczęśliwie, wiele typów WZW można skutecznie zapobiegać poprzez szczepienia, odpowiednie zachowania profilaktyczne oraz wczesną interwencję po ekspozycji. W niniejszym artykule omówiono kompleksowe strategie zapobiegania różnym typom wirusowego zapalenia wątroby, ze szczególnym uwzględnieniem WZW typu A, B i C.12
Szczepienia jako podstawowa metoda profilaktyki
Szczepienia stanowią najskuteczniejszą metodę zapobiegania zakażeniom WZW typu A i B. Dostępne szczepionki są bezpieczne i wysoce skuteczne, oferując prawie 100% ochronę przed zakażeniem.12
Szczepienia przeciwko WZW typu A
Szczepionka przeciwko WZW typu A jest zalecana dla następujących grup:12
- Wszystkie dzieci w wieku 12-23 miesięcy
- Osoby podróżujące do krajów o wysokiej endemiczności WZW typu A
- Osoby z przewlekłymi chorobami wątroby
- Mężczyźni mający kontakty seksualne z mężczyznami
- Osoby używające narkotyków
- Osoby z zaburzeniami krzepnięcia
Szczepionka przeciwko WZW typu A jest podawana w dwóch dawkach w odstępie 6-12 miesięcy. Ochrona rozpoczyna się 2-4 tygodnie po pierwszym wstrzyknięciu, a druga dawka zapewnia długotrwałą ochronę. Skuteczność szczepionki wynosi 94-100% w zapobieganiu chorobie.12
Szczepienia przeciwko WZW typu B
Szczepionka przeciwko WZW typu B jest zalecana dla następujących grup:12
- Wszystkie noworodki (najlepiej w ciągu 24 godzin po urodzeniu)
- Dzieci i młodzież do 18 roku życia, które nie były wcześniej szczepione
- Dorośli w wieku 19-59 lat
- Dorośli w wieku 60 lat i starsi z czynnikami ryzyka zakażenia
- Osoby z przewlekłymi chorobami wątroby lub nerek
- Osoby zakażone HIV
- Osoby z wieloma partnerami seksualnymi
- Mężczyźni mający kontakty seksualne z mężczyznami
- Osoby przyjmujące narkotyki drogą dożylną
- Pracownicy ochrony zdrowia
Standardowy schemat szczepienia przeciwko WZW typu B obejmuje trzy dawki podawane w ciągu 6 miesięcy. W 2017 roku FDA zatwierdziła szczepionkę Heplisav-B (Dynavax), która jest podawana w dwóch dawkach dla dorosłych w wieku 18 lat i starszych. Szczepionka przeciwko WZW typu B zapewnia skuteczną ochronę przez co najmniej 10 lat, a u większości zaszczepionych osób ochrona utrzymuje się przez całe życie.12
Warto podkreślić, że szczepienie przeciwko WZW typu B zapewnia również ochronę przed zakażeniem WZW typu D, ponieważ wirus ten może zainfekować tylko osoby zakażone wirusem HBV.12
Profilaktyka WZW typu C
Aktualnie nie istnieje szczepionka przeciwko wirusowi zapalenia wątroby typu C (HCV). Profilaktyka HCV opiera się głównie na zapobieganiu ekspozycji na zakażoną krew poprzez:123
- Unikanie używania wspólnych igieł i innego sprzętu do iniekcji narkotyków
- Stosowanie bezpiecznych metod seksualnych, w tym prezerwatyw
- Zapewnienie bezpieczeństwa transfuzji krwi i procedur medycznych
- Stosowanie środków ostrożności przez pracowników służby zdrowia
- Unikanie niekontrolowanych tatuaży i piercingu
Istotnym elementem zapobiegania rozprzestrzenianiu się HCV jest wczesne wykrywanie zakażenia poprzez badania przesiewowe osób z grup ryzyka. Centers for Disease Control and Prevention (CDC) zaleca, aby wszyscy dorośli w wieku 18 lat i starsi zostali przynajmniej raz w życiu przebadani w kierunku HCV.12
Profilaktyka okołoporodowa WZW
Zapobieganie okołoporodowej transmisji WZW typu B jest krytycznie ważne, ponieważ zakażenie w okresie noworodkowym wiąże się z wysokim ryzykiem rozwoju przewlekłego zakażenia i poważnych powikłań, w tym raka wątroby.12
Badania przesiewowe u kobiet ciężarnych
Wszystkie kobiety ciężarne powinny być badane na obecność antygenu powierzchniowego wirusa zapalenia wątroby typu B (HBsAg) podczas pierwszej wizyty prenatalnej w każdej ciąży.12
W przypadku kobiet z grup wysokiego ryzyka lub mieszkających w obszarach o wysokiej częstości występowania zakażeń, badanie powinno być powtórzone w trzecim trymestrze ciąży.1
Profilaktyka u noworodków
U noworodków urodzonych przez matki HBsAg-pozytywne należy zastosować następującą profilaktykę:123
- Immunoglobulina przeciwko wirusowemu zapaleniu wątroby typu B (HBIG) w dawce 0,5 ml, podana domięśniowo w ciągu 12 godzin po urodzeniu
- Pierwsza dawka szczepionki przeciwko WZW typu B, podana domięśniowo w osobnym miejscu, również w ciągu 12 godzin po urodzeniu
- Dokończenie serii szczepień przeciwko WZW typu B według schematu 0, 1-2 i 6 miesięcy
Ta profilaktyka zapobiega zakażeniu HBV u 85-95% noworodków.12
Wszystkie noworodki, niezależnie od statusu HBsAg matki, powinny otrzymać pierwszą dawkę szczepionki przeciwko WZW typu B w ciągu 24 godzin po urodzeniu.12
Badania po szczepieniu
U niemowląt urodzonych przez matki HBsAg-pozytywne zaleca się przeprowadzenie badań serologicznych po szczepieniu (PVST) 3-9 miesięcy po ukończeniu serii szczepień, aby upewnić się, że dziecko jest chronione.12
Profilaktyka poekspozycyjna
W przypadku ekspozycji na WZW typu A lub B, szybkie wdrożenie odpowiednich środków profilaktycznych może zapobiec rozwojowi zakażenia.12
Profilaktyka WZW typu A po ekspozycji
Osoby, które miały kontakt z osobą zakażoną WZW typu A w ciągu ostatnich 2 tygodni, powinny otrzymać:12
- Pojedynczą dawkę szczepionki przeciwko WZW typu A, jeśli wcześniej nie były szczepione
- W niektórych przypadkach może być podana immunoglobulina (IG), zwłaszcza osobom z obniżoną odpornością lub przewlekłymi chorobami wątroby
Profilaktyka powinna być zastosowana w ciągu 2 tygodni od ekspozycji, aby była skuteczna.1
Profilaktyka WZW typu B po ekspozycji
W przypadku ekspozycji na WZW typu B profilaktyka poekspozycyjna (PEP) powinna obejmować:123
- Immunoglobulina przeciwko WZW typu B (HBIG) podana jak najszybciej, najlepiej w ciągu 24 godzin od ekspozycji
- Rozpoczęcie serii szczepień przeciwko WZW typu B dla osób nieimmunizowanych
- U osób, które odmówią szczepienia, można podać drugą dawkę HBIG miesiąc po pierwszej
PEP przeciwko WZW typu B jest najskuteczniejsza, gdy zostanie podana jak najszybciej po ekspozycji, ale powinna być zastosowana w ciągu 72 godzin.12
Profilaktyka reaktywacji WZW u osób z immunosupresją
Pacjenci z przebytym lub przewlekłym zakażeniem HBV, którzy mają być poddani terapii immunosupresyjnej, są narażeni na ryzyko reaktywacji wirusa. Amerykańskie Towarzystwo Gastroenterologiczne (AGA) zaleca następujące podejście do profilaktyki reaktywacji WZW typu B:123
Ocena ryzyka reaktywacji
Wszyscy pacjenci przed rozpoczęciem terapii immunosupresyjnej powinni być przebadani na obecność:12
- Antygenu powierzchniowego wirusa zapalenia wątroby typu B (HBsAg)
- Przeciwciał przeciwko antygenowi powierzchniowemu (HBsAb)
- Przeciwciał przeciwko antygenowi rdzeniowemu (HBcAb)
Profilaktyka przeciwwirusowa
W zależności od poziomu ryzyka reaktywacji:12
- Wysokie ryzyko reaktywacji: Zalecana jest profilaktyka przeciwwirusowa przed rozpoczęciem terapii immunosupresyjnej i przez 6-12 miesięcy po jej zakończeniu
- Umiarkowane ryzyko reaktywacji: Sugerowana jest profilaktyka przeciwwirusowa, ale można rozważyć regularne monitorowanie na podstawie preferencji pacjenta
- Niskie ryzyko reaktywacji: Preferowane jest monitorowanie, ale można rozważyć leczenie przeciwwirusowe dla pacjentów przyjmujących wiele leków immunosupresyjnych o niskim ryzyku
Do profilaktyki reaktywacji HBV zaleca się stosowanie analogów nukleotydów/nukleozydów o wysokiej barierze oporności, takich jak entekawir lub tenofowir.12
Ogólne środki zapobiegawcze
Oprócz szczepień i profilaktyki poekspozycyjnej, istnieją ogólne środki zapobiegawcze, które mogą zmniejszyć ryzyko zakażenia wszystkimi typami WZW:123
Higiena osobista
Dokładne mycie rąk wodą i mydłem, szczególnie:12
- Po korzystaniu z toalety
- Przed przygotowywaniem lub spożywaniem posiłków
- Po zmianie pieluch
- Po kontakcie z krwią lub płynami ustrojowymi
Bezpieczne zachowania seksualne
Stosowanie prezerwatyw podczas stosunków seksualnych i ograniczenie liczby partnerów seksualnych może zmniejszyć ryzyko przeniesienia WZW.12
Unikanie współdzielenia przedmiotów
Nie należy dzielić się przedmiotami osobistymi, które mogą mieć kontakt z krwią lub innymi płynami ustrojowymi, takimi jak:12
- Igły i strzykawki
- Maszynki do golenia
- Szczoteczki do zębów
- Sprzęt do przygotowywania i wstrzykiwania narkotyków
Bezpieczeństwo podczas podróży
Podczas podróży do krajów o wysokiej endemiczności WZW typu A i E:12
- Pić tylko butelkowaną lub przegotowaną wodę
- Unikać spożywania surowych owoców i warzyw, chyba że można je obrać samodzielnie
- Unikać spożywania niedogotowanego mięsa
- Nie używać wody z kranu do mycia zębów lub robienia kostek lodu
Programy profilaktyki WZW na poziomie krajowym i globalnym
Na całym świecie wdrażane są kompleksowe programy i strategie mające na celu zapobieganie i kontrolę wirusowego zapalenia wątroby.12
Strategiczne działania
Skuteczne programy profilaktyki WZW obejmują:12
- Zwiększenie dostępu do szczepień przeciwko WZW typu A i B
- Badania przesiewowe osób z grup ryzyka
- Profilaktyka w grupach szczególnego ryzyka (np. osoby przyjmujące narkotyki drogą dożylną)
- Programy wymiany igieł i strzykawek
- Leczenie osób zakażonych jako forma profilaktyki rozprzestrzeniania się wirusa
- Poprawa bezpieczeństwa krwi i procedur medycznych
- Edukacja społeczeństwa na temat dróg transmisji i metod profilaktyki
Globalne cele eliminacji WZW
Światowa Organizacja Zdrowia (WHO) wyznaczyła cele eliminacji wirusowego zapalenia wątroby jako zagrożenia dla zdrowia publicznego do 2030 roku. Cele te obejmują:12
- 95% zasięg szczepień przeciwko WZW typu B u dzieci
- 90% zasięg szczepień przeciwko WZW typu B u noworodków po urodzeniu
- 100% badań krwi do transfuzji pod kątem WZW typu B i C
- Zwiększenie dostępu do programów redukcji szkód dla osób przyjmujących narkotyki drogą dożylną
- Diagnozowanie i leczenie przewlekłych zakażeń WZW typu B i C
Pomimo postępów w wielu krajach, wciąż istnieją luki w danych dotyczących działań profilaktycznych oraz nierówności w dostępie do szczepień i programów redukcji szkód.12
Wnioski i przyszłe kierunki działań
Profilaktyka wirusowego zapalenia wątroby wymaga kompleksowego podejścia obejmującego szczepienia, badania przesiewowe, profilaktykę poekspozycyjną oraz edukację społeczeństwa. Chociaż poczyniono znaczne postępy w zmniejszaniu obciążenia WZW na całym świecie, nadal istnieje potrzeba:12
- Zwiększenia zasięgu szczepień przeciwko WZW typu A i B
- Rozwoju szczepionki przeciwko WZW typu C
- Poprawy dostępu do testów diagnostycznych, w tym testów typu point-of-care
- Eliminacji barier w dostępie do leczenia przeciwwirusowego
- Wzmocnienia krajowych systemów nadzoru i monitorowania
- Zwiększenia świadomości społecznej na temat WZW i metod profilaktyki
Dzięki skutecznym szczepionkom, lepszym metodom diagnostycznym i nowym terapiom przeciwwirusowym, eliminacja wirusowego zapalenia wątroby jako zagrożenia dla zdrowia publicznego jest osiągalnym celem. Wymaga to jednak skoordynowanych wysiłków na poziomie lokalnym, krajowym i globalnym, a także zaangażowania podmiotów publicznych i prywatnych w walkę z tą chorobą.123
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Materiały źródłowe
- #1 Hepatitis B Prevention and Control | Hepatitis B | CDChttps://www.cdc.gov/hepatitis-b/prevention/index.html
Hepatitis B spreads when someone comes in contact with the bodily fluids of a person who is infected. […] The best way to prevent hepatitis B is by getting vaccinated. […] CDC recommends that everyone who is eligible receive hepatitis B vaccination to protect themselves. […] The best way to prevent hepatitis B is by getting vaccinated. Hepatitis B vaccine is safe and effective, and CDC recommends it for almost everyone. […] If you are pregnant, there are steps you can take to protect your family: […] All pregnant women should get a blood test for hepatitis B as part of their prenatal care. […] Your baby’s family members and anyone else who lives in the household should get tested and vaccinated if needed. […] All babies will get hepatitis B vaccine shortly after birth. […] If you have hepatitis B, the baby should get another shot called hepatitis B immune globulin (HBIG).
- #1https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B can be prevented by vaccines that are safe, available and effective. […] Hepatitis B can be prevented with a safe and effective vaccine. The vaccine is usually given soon after birth with boosters a few weeks later. It offers nearly 100% protection against the virus. […] Hepatitis B is preventable with a vaccine. All babies should receive the hepatitis B vaccine as soon as possible after birth (within 24 hours). This is followed by two or three doses of hepatitis B vaccine at least four weeks apart. […] Hepatitis B can be passed from mother to child. This can be prevented by taking antiviral medicines to prevent transmission, in addition to the vaccine. […] To reduce the risk of getting or spreading hepatitis B: practice safe sex by using condoms and reducing the number of sexual partners; avoid sharing needles or any equipment used for injecting drugs, piercing, or tattooing; wash your hands thoroughly with soap and water after coming into contact with blood, body fluids, or contaminated surfaces; get a hepatitis B vaccine if working in a healthcare setting.
- #1 Know The ABC’s of Hepatitis Prevention – NFIDhttps://www.nfid.org/know-the-abcs-of-hepatitis-prevention/
Hepatitis Awareness Month, held each May in the US, is a month-long observance designed to raise awareness of viral hepatitis prevention, diagnosis, and treatment and to encourage at-risk populations to get tested and ensure they are up-to-date with recommended vaccines. […] Fortunately, effective vaccines are available to help prevent hepatitis A and hepatitis B. […] Although hepatitis A vaccination is recommended for children starting at age 12-23 months, unfortunately, many US children remain unvaccinated and vulnerable to infection. […] Vaccination can prevent HBV infection and related complications. […] In the US, hepatitis B vaccination is given within 24 hours of birth, as well as to children and adolescents who have not been vaccinated previously and to adults at risk for HBV infection. […] There is currently no vaccine available to help prevent HCV. The best way to prevent the disease is to avoid behaviors that cause its spread, particularly injecting recreational drugs.
- #1 Hepatitis A: Symptoms, Causes, Treatment, and Preventionhttps://www.healthline.com/health/hepatitis-a
The No. 1 way to avoid getting hepatitis A is by getting the hepatitis A vaccine. This vaccine is given in a series of two injections, 6 to 12 months apart. […] If youâre traveling to a country where hepatitis A transmission is more common, get your vaccination at least 2 weeks before traveling. It usually takes 2 weeks after the first injection for your body to start building immunity to hepatitis A. […] To limit your chance of contracting hepatitis A, you should also: thoroughly wash your hands with soap and warm water before eating or drinking, and after using the restroom; drink bottled water rather than local water in developing countries, or in countries where thereâs a high risk of contracting hepatitis A; dine at established, reputable restaurants, rather than from street vendors; avoid eating peeled or raw fruit and vegetables in an area with low sanitation or hygienic standards.
- #1 Hepatitis B Foundation: Hepatitis B Vaccinationhttps://www.hepb.org/prevention-and-diagnosis/vaccination/
It takes only a few shots to protect yourself and your loved ones against hepatitis B for a lifetime. […] The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. […] The hepatitis B vaccine is also recommended for adults living with diabetes and those at high risk for infection due to their jobs, lifestyle, living situations, or country of birth. […] Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease. […] The World Health Organization (WHO) recommends the hepatitis B vaccine for all newborns, children up to 18 years of age, and all adults at higher risk for infection. […] The U.S. Centers for Disease Control and Prevention (CDC) recommends the hepatitis B vaccine for all newborns, children up to age 18, adults 19-59 years of age, and adults 60 and older who are at high-risk for infection.
- #1 Preventing Hepatitis | NYU Langone Healthhttps://nyulangone.org/conditions/hepatitis/prevention
NYU Langone doctors recommend specific preventive steps for each type to limit your risk of acquiring or spreading infection. […] Vaccines for hepatitis A and hepatitis B are the most effective preventive measures against those viruses. […] Vaccination provides long-term protection from infection. Even if you have recently been exposed to the hepatitis A or B virus, these vaccines may prevent infection. […] Hepatitis B vaccination also helps protect against hepatitis D, since only people infected with hepatitis B can get hepatitis D. […] There is no vaccine for hepatitis C. Our doctors recommend adopting certain behaviors such as avoiding shared needles and other risk factors to prevent infection. […] To protect against hepatitis E, avoid drinking unpurified water and eating undercooked meat when traveling in countries where the virus is common.
- #1 Strategies to prevent and control hepatitis B and C virus infections: a global perspective – PubMedhttps://pubmed.ncbi.nlm.nih.gov/10194830/
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of acute and chronic liver disease worldwide. […] Comprehensive hepatitis B prevention strategies should include (1) prevention of perinatal HBV transmission, (2) hepatitis B vaccination at critical ages to interrupt transmission and (3) prevention of nosocomial HBV transmission. […] The prevention of hepatitis C is problematic because a vaccine to prevent HCV infection is not expected to be developed in the foreseeable future. […] From a global perspective, the greatest impact on the disease burden associated with HCV infection will most likely be achieved by focusing efforts on primary prevention strategies to reduce or eliminate the risk for transmission from nosocomial exposures (e.g. blood transfusion, unsafe injection practices) and high-risk practices (e.g. injecting drug use).
- #1 Hepatitis: Symptoms, Treatment and Prevention |Banner Healthhttps://www.bannerhealth.com/services/gastroenterology/treatment/hepatitis
Hepatitis is a condition that causes inflammation of the liver, an important organ that helps your body absorb nutrients, filter toxins, and fight infections. […] The Centers for Disease Control and Prevention (CDC) recommends that all adults age 18 and older get screened for hepatitis C at least once. […] You can take these steps to reduce your risk of being infected with hepatitis: […] Get vaccinated for hepatitis A and B. Children up to age 18 should get the hepatitis A and B vaccines if they haven’t already. Everyone up to age 59 should be vaccinated for hepatitis B if they haven’t been. […] Vaccinations for hepatitis A and B can protect you and your loved ones from getting infected. Both shots are part of the CDC’s recommended vaccine schedule for children; however, you can get the vaccines as an adult if you did not get them as a child.
- #1 Hepatitis B Prevention and Control | Hepatitis B | CDChttps://www.cdc.gov/hepatitis-b/prevention/index.html
Preventing perinatal hepatitis B is important because most people with hepatitis B got infected as infants or young children when their immune systems were not fully developed. […] Chronic hepatitis B can lead to severe complications, including liver failure, liver cancer, and even death. […] CDC recommends hepatitis B vaccine for all infants, children, adults through age 59, and adults age 60 and over with risk factors.
- #1 Prevention of Perinatal Hepatitis B Virus Transmissionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC4164184/
Hepatitis B virus (HBV) infection, the most common form of chronic hepatitis worldwide, is a major public health problem affecting an estimated 360 million people globally. […] Screening pregnant women for HBV infection, providing infant postexposure prophylaxis, and maternal treatment with antiviral medications are strategies for reducing MTCT transmission rates and the global burden of new chronic HBV infections. […] Administration of hepatitis B immune globulin (HBIG) and hepatitis B (HepB) vaccine within 24 hours of birth, followed by completion of the vaccine series, is 85%95% efficacious for prevention of MTCT. […] The Advisory Committee on Immunization Practices (ACIP) recommends screening pregnant women (including women previously vaccinated or previously tested) for HBsAg during the first prenatal visit of each pregnancy.
- #1 Health: HIV/STI/Viral Hepatitis: Perinatal Infection Prevention Programhttps://www.in.gov/health/hiv-std-viral-hepatitis/hiv-prevention/perinatal-infection-prevention-program/
HCV can be transmitted from an infected mother to her child during the birthing process. Pregnant women who are at increased risk (past or current injection-drug use, with HIV infection, having had a blood transfusion before July 1992, having received an unregulated tattoo, having been on long-term hemodialysis, intranasal drug use, and other percutaneous exposures) should be tested for HCV at the first prenatal visit. […] All pregnant women should be tested for HIV at an early prenatal visit during each pregnancy. […] The earlier HIV is diagnosed and treated, the more effective HIV medicine, called antiretroviral treatment (ART), will be at preventing transmission and improving the health outcomes of both mother and child. […] All pregnant women should be tested for syphilis during the first trimester and again during the third trimester for women who are at high risk or live in areas of high syphilis morbidity. […] Is recommended for pregnant women and safe to administer during any trimester. […] Is recommended during every pregnancy, ideally during the third trimester.
- #1https://www.oregon.gov/oha/ph/preventionwellness/vaccinesimmunization/perinatalhepatitisb/pages/index.aspx
The Perinatal Hepatitis B Prevention Program (PHBPP) works to ensure all children, especially those exposed at birth, are protected against hepatitis B virus. The goal of the PHBPP is to prevent perinatal transmission of hepatitis B by ensuring: […] All women receive prenatal testing for hepatitis B infection, with every pregnancy, and all cases are reported to local public health authorities […] Infants born to mothers with hepatitis B receive the appropriate treatment […] Exposed infants complete post vaccination testing […] Close contacts receive screening and vaccination […] All medically stable infants receive the first dose of hepatitis B immunization within 24 hours of birth.
- #1 Prevention of Perinatal Hepatitis B Virus Transmissionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC4164184/
In 2005, ACIP recommended HepB vaccine for all infants of HBsAg-negative pregnant women to be administered as soon as feasible but before discharge from the birthing hospital. […] ACIP recommends post-HepB vaccination testing (PVST) for all infants born to HBsAg-positive women. […] More than 90% of term infants who receive PEP and complete at least 3 doses of HepB vaccine achieve concentrations of antibody associated with protection (anti-HBs 10 mIU/mL). […] Preliminary results suggest antiviral prophylaxis in late pregnancy for highly viremic women is effective in suppressing viral load and reducing MTCT. […] Guidelines recommend treatment for noncirrhotic patients (including pregnant women) with serum HBV DNA levels greater than 20 000 IU/mL (105 copies/mL) and evidence of liver disease.
- #1 Hepatitis A Prevention and Control | Hepatitis A | CDChttps://www.cdc.gov/hepatitis-a/prevention/index.html
Hepatitis A is a highly contagious virus that spreads through person-to-person contact or consuming contaminated food or drink. […] Vaccination is the best way to prevent hepatitis A. […] Hepatitis A vaccine is the best way to prevent HAV infection. Practicing good hand hygiene can also prevent the spread of hepatitis A. […] The best way to prevent getting infected is by getting vaccinated. […] If you have been exposed to HAV in the last 2 weeks, talk to your doctor. They can give you a single shot of hepatitis A vaccine within 2 weeks of exposure that can help prevent you from getting sick. […] Practicing good hand hygiene can also prevent the spread of hepatitis A. […] Almost anyone can get the safe and effective hepatitis A vaccine and prevent serious complications. […] While handwashing is important while traveling, the best way to prevent an infection is through vaccination.
- #1 Hepatitis B Post-Exposure Treatmenthttps://www.hepb.org/prevention-and-diagnosis/post-exposure-treatment/
If an uninfected, unvaccinated person – or anyone who does not know their hepatitis B status – is exposed to the hepatitis B virus through contact with infected blood, a timely postexposure prophylaxis (PEP) can prevent an infection and subsequent development of a chronic infection or liver disease. […] Any person who is uninfected/unvaccinated or does not know their hepatitis B status should receive postexposure prophylaxis after contact with potentially infected blood. […] Neither pregnancy nor breastfeeding should be considered a contraindication to administration of the hepatitis B vaccination and HBIG to women.
- #1 Hepatitis B exposure – post exposure prophylaxis (PEP) | SA Healthhttps://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/clinical+programs+and+practice+guidelines/infectious+disease+control/hepatitis+b+exposure+pep/hepatitis+b+exposure+post+exposure+prophylaxis+pep
Hepatitis B is a serious viral infection that causes inflammation of the liver. […] After possible exposure to the hepatitis B virus, hepatitis B post-exposure prophylaxis (PEP) can be used to decrease the chance of getting hepatitis B. […] Hepatitis B PEP must be given within 72 hours, though it is most effective if given as early as possible. […] Hepatitis B PEP is available from hospital emergency departments, although you may be able to get it through your workplace if your exposure was at work. […] Hepatitis B vaccination is recommended as part of the routine vaccinations for infants. Hepatitis B vaccination is also available free for people at higher risk of getting hepatitis B and recommended for people at higher risk of severe disease. […] In Australia, women who are pregnant are routinely tested for hepatitis B. If the mother has hepatitis B, her baby should be given hepatitis B PEP within 24 hours of birth.
- #1 New AGA Guidelines Recommend Risk-Based Prophylaxis for Hepatitis B Reactivation Monitoringhttps://www.ajmc.com/view/new-aga-guidelines-recommend-risk-based-prophylaxis-for-hepatitis-b-reactivation-monitoring
Updated guidelines emphasize antiviral prophylaxis for high and moderate-risk patients, refining 2015 recommendations with detailed risk-based strategies. […] The American Gastroenterology Association (AGA) updated its clinical practice guidelines for managing hepatitis B reactivation (HBVr) in at-risk individuals, recommending antiviral prophylaxis for high- and moderate-risk patients. […] The guidelines provided 4 key recommendations for managing HBVr risk, based on patient risk level: High-risk of HBVr: Antiviral prophylaxis is recommended before starting risk-imposing therapy and for 6 to 12 months after discontinuation […] Moderate-risk of HBVr: Antiviral prophylaxis is suggested, but monitoring may be chosen based on patient preferences, with regular assessments […] Low-risk of HBVr: Monitoring alone is preferred, but antiviral therapy can be considered for patients on multiple low-risk immunosuppressive medications
- #1 Prevention of Hepatitis B Reactivation During Immunosuppressive Therapy Hepatitis B – Viral Hepatitis and Liver Diseasehttps://www.hepatitis.va.gov/hbv/reactivation-prevention.asp
Test all patients for HBsAg, HBsAb, and HBcAb Total (IgG) (if not done in the last 6 months). […] Immunize for HBV if the patient is not exposed (HbcAb is negative) nor immune (HBcAB and HBsAb are both negative). Note, immunizations may be effective if given less than 4 weeks prior to a B cell depleting agent such as Rituximab and may need to be offered 6 months after completion of therapy. […] If the HBsAg and/or HBcAb (Total) is detectable, order tests for hepatitis B viral load (HBV-DNA) and ALT and consider additional factors for risk determination: […] If the HBV DNA is detectable, or if there is evidence of advanced liver disease, refer the patient to a hepatology or infectious disease specialist for evaluation. Chemotherapy for cancer should not be delayed and HBV antiviral prophylaxis can be initiated until a risk assessment is completed. […] If the patient is high or moderate risk, refer to Table 3: HBV Antiviral Medication Options for reactivation prophylaxis.
- #1 Hepatitis B virus prophylaxis in immunocompromised adultshttps://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/prophylaxis-and-treatment/1382-hepatitis-b-virus-prophylaxis-in-immunocompro
Recommendations […] Antiviral prophylaxis with a potent, high barrier to resistance nucleoside/nucleotide analogues (i.e. entecavir or tenofovir) is recommended over lamivudine. […] Antiviral prophylaxis is recommended for all HBsAg positive patients with haematological malignancy or solid tumour undergoing therapy. […] In patients who are HBsAg negative and anti-HBc positive the cancer therapy regimen determines the risk for HBV reactivation. […] Antiviral prophylaxis with a nucleoside/nucleotide analogue should be continued post cessation of therapy for: 18 to 24 months in patients who received higher risk cancer therapy. […] Recommendations on the duration of antiviral prophylaxis differ across international guidelines, ranging from 6 to 12 months after the cessation of chemotherapy, and for 12 to 24 months after the cessation of anti-CD20 monoclonal antibodies or BMT to reduce the risk of HBV reactivation which may occur after the withdrawal of antiviral therapy. […] Immunisation against hepatitis B is recommended for patients who are HBV naive and BMT donors. […] Entecavir or tenofovir is recommended as first-line antiviral therapy and should be initiated as soon as possible relative to the start of anti-cancer therapy. […] During antiviral prophylaxis, ALT and HBV DNA levels should be monitored every 3 months. […] Testing for HBV DNA, ALT and HBsAg is recommended every 3 months for a minimum of 12 months after cessation of antiviral prophylaxis to monitor for an increase in HBV DNA levels.
- #1 Viral Hepatitis: What It Is, Symptoms, Causes & Treatmenthttps://my.clevelandclinic.org/health/diseases/4245-hepatitis-viral-hepatitis-a-b–c
Vaccines can help prevent some types of viral hepatitis. […] There are vaccines that prevent viral hepatitis A and B. You can reduce your risk of developing other types of viral hepatitis if you: […] Use a condom during sex […] Don’t share needles to take drugs […] Practice good personal hygiene, like thorough handwashing with soap and water. […] You can prevent some viral hepatitis infections by receiving vaccinations. There aren’t vaccines for all types of viral hepatitis. But there are ways to reduce the risk you’ll get those viruses. Start by understanding how the viruses spread. Then, take steps to avoid activities that put you at risk.
- #1 Preventing hepatitis B or C: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/patientinstructions/000401.htm
Hepatitis B and C viruses are spread through contact with blood or bodily fluids of a person with the virus. […] To avoid coming in contact with blood or bodily fluids of others: Avoid sharing personal items, such as razors or toothbrushes, Do not share drug needles or other drug equipment (such as straws for snorting drugs), Clean blood spills with a solution containing 1 part household bleach to 9 parts water, Be careful when getting tattoos and body piercings, Practice safe sex (especially for prevention of hepatitis B). […] Screening of all donated blood has reduced the chance of getting hepatitis B and C from a blood transfusion. […] The hepatitis B vaccine, or an HBIG shot, may help prevent infection if it is received within 24 hours of contact with the virus.
- #1 Viral Hepatitis National Strategic Plan Overview | HHS.govLockhttps://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html
Aims to increase uptake of hepatitis vaccination among populations for whom vaccination is recommended, increase access to harm reduction services, substance use treatment and peer navigation and utilize a treatment as prevention approach […] Seeks to implement universal hepatitis C screening guidelines, hepatitis B testing, and linkage to care in a range of settings and expand the capacity of the public health and provider workforce to provide viral hepatitis prevention, testing, care and treatment services […] Seeks to implement strategies and promote policies to enhance collaborative, integrated, patient-centered models of care […] Focuses on opportunities to expand research and development of a hepatitis C vaccine, point of care testing and improved diagnostics and therapeutics. The Plan also focuses on implementation research to put into practice evidence-based interventions, as effective interventions to improve prevention, testing and treatment are identified […] Aims to improve viral hepatitis surveillance data collection, management, and analysis, including interoperability of data and data sharing, to understand the true scope, level of public health threat, and opportunities to address viral hepatitis.
- #1 Prevention of hepatitis B and C in the EU/EEA, 2024https://www.ecdc.europa.eu/en/publications-data/prevention-hepatitis-b-and-c-eueea-2024
There are gaps in the data available on hepatitis prevention activities across the EU/EEA, highlighting the need for countries to prioritise the collection of more complete monitoring data to properly assess progress towards the elimination targets. […] Available data show that progress across the EU/EEA region is variable, with many countries currently not meeting 2025 interim WHO European Action Plan hepatitis prevention targets, especially targets focussing on programmes for people who inject drugs (PWIDs). Continued investment and strengthening of hepatitis prevention programmes is needed. […] The hepatitis B vaccine is an important tool for hepatitis B prevention, but less than 40% of EU/EEA countries with a universal childhood vaccination programme have reached the target of 95% hepatitis B vaccination coverage.
- #1 New AGA Guidelines Recommend Risk-Based Prophylaxis for Hepatitis B Reactivation Monitoringhttps://www.ajmc.com/view/new-aga-guidelines-recommend-risk-based-prophylaxis-for-hepatitis-b-reactivation-monitoring
To address these gaps, future research should focus on establishing and maintaining national registries and leveraging technological innovations, such as an online repository for periodically updated risk data. These efforts could enhance the accuracy of baseline risk estimates and improve HBVr prevention strategies in the evolving landscape of immunotherapeutics.
- #1 Viral Hepatitis Prevention and Surveillance VLC | NASTADhttps://nastad.org/hepatitis-vlc
The VLC is a virtual learning community and training series designed to support viral hepatitis health department staff in implementing the viral hepatitis prevention and surveillance activities set forth in CDCs Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments (CDC-RFA-PS21-2103) and is open to all state, territorial, and local health departments. […] Each month there will be two VLC sessions, rotating between prevention and surveillance topics. […] Attendees register once and can attend any of the prevention and surveillance sessions. […] Improving provider awareness and capacity to increase viral hepatitis testing and treatment, Part 2 […] Working across the health department and with other state agencies to increase collaboration on viral hepatitis prevention and surveillance activities.
- #2 Hepatitis A Prevention and Control | Hepatitis A | CDChttps://www.cdc.gov/hepatitis-a/prevention/index.html
Hepatitis A is a highly contagious virus that spreads through person-to-person contact or consuming contaminated food or drink. […] Vaccination is the best way to prevent hepatitis A. […] Hepatitis A vaccine is the best way to prevent HAV infection. Practicing good hand hygiene can also prevent the spread of hepatitis A. […] The best way to prevent getting infected is by getting vaccinated. […] If you have been exposed to HAV in the last 2 weeks, talk to your doctor. They can give you a single shot of hepatitis A vaccine within 2 weeks of exposure that can help prevent you from getting sick. […] Practicing good hand hygiene can also prevent the spread of hepatitis A. […] Almost anyone can get the safe and effective hepatitis A vaccine and prevent serious complications. […] While handwashing is important while traveling, the best way to prevent an infection is through vaccination.
- #2 Preventing Hepatitis | NYU Langone Healthhttps://nyulangone.org/conditions/hepatitis/prevention
NYU Langone doctors recommend specific preventive steps for each type to limit your risk of acquiring or spreading infection. […] Vaccines for hepatitis A and hepatitis B are the most effective preventive measures against those viruses. […] Vaccination provides long-term protection from infection. Even if you have recently been exposed to the hepatitis A or B virus, these vaccines may prevent infection. […] Hepatitis B vaccination also helps protect against hepatitis D, since only people infected with hepatitis B can get hepatitis D. […] There is no vaccine for hepatitis C. Our doctors recommend adopting certain behaviors such as avoiding shared needles and other risk factors to prevent infection. […] To protect against hepatitis E, avoid drinking unpurified water and eating undercooked meat when traveling in countries where the virus is common.
- #2 Hepatitis – NFIDhttps://www.nfid.org/infectious-disease/hepatitis/
Hepatitis A vaccination is the best way to prevent HAV infection. The hepatitis A vaccine is 94-100% effective in preventing the disease. Protection begins approximately 2-4 weeks after the first injection. A second injection results in long-term protection. The Centers for Disease Control and Prevention (CDC) recommends hepatitis A vaccination for the following: […] Vaccination is the best way to prevent HBV infection and potential complications, including liver cancer. Hepatitis B vaccination is recommended for all infants, older children and adolescents who were not previously vaccinated, all adults age 19-59 years, and adults age 60 years or older with risk factors or for those seeking protection from hepatitis B. […] There is currently no vaccine to prevent hepatitis C. The best way to prevent HCV infection is to avoid contact with contaminated blood and avoid high-risk behaviors including intravenous drug use and unprotected sex. Screening and testing are also important.
- #2https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B can be prevented by vaccines that are safe, available and effective. […] Hepatitis B can be prevented with a safe and effective vaccine. The vaccine is usually given soon after birth with boosters a few weeks later. It offers nearly 100% protection against the virus. […] Hepatitis B is preventable with a vaccine. All babies should receive the hepatitis B vaccine as soon as possible after birth (within 24 hours). This is followed by two or three doses of hepatitis B vaccine at least four weeks apart. […] Hepatitis B can be passed from mother to child. This can be prevented by taking antiviral medicines to prevent transmission, in addition to the vaccine. […] To reduce the risk of getting or spreading hepatitis B: practice safe sex by using condoms and reducing the number of sexual partners; avoid sharing needles or any equipment used for injecting drugs, piercing, or tattooing; wash your hands thoroughly with soap and water after coming into contact with blood, body fluids, or contaminated surfaces; get a hepatitis B vaccine if working in a healthcare setting.
- #2 Hepatitis B Foundation: Hepatitis B Vaccinationhttps://www.hepb.org/prevention-and-diagnosis/vaccination/
Every person may be at some risk for a hepatitis B infection during their lifetime, so all people should consider getting the hepatitis B vaccine. […] The hepatitis B vaccine is available at your doctor’s office and local health department or clinic. […] All doses of the vaccine are required in order to be fully protected against hepatitis B. […] It is important to remember that babies born to infected mothers must receive the first dose of hepatitis B vaccine in the delivery room or within the first 12 hours of life. […] To be certain that you are protected against hepatitis B, ask for a simple blood test to check your antibody titers that will confirm whether the vaccination was successful. […] In November 2017, a vaccine was approved by the FDA for use in the U.S. Heplisav-B (Dynavax) is a two-dose vaccine approved for use in adults aged 18 and older. […] More than 1 billion doses of the hepatitis B vaccine have been given worldwide and it is considered one of the safest and most effective vaccines ever made. […] Common side effects from the hepatitis B vaccine may include soreness, swelling and redness at the injection site.
- #2 Hepatitis – NFIDhttps://www.nfid.org/infectious-disease/hepatitis/
There is no vaccine for hepatitis D, but getting vaccinated against hepatitis B also protects against hepatitis D. […] No vaccine for hepatitis E is currently available to protect against hepatitis E. The risk for HEV infection can be lowered by drinking only purified water when visiting countries where hepatitis E is common and by avoiding raw or undercooked meats.
- #2 CDC hepatitis lab closes through RIF, imperiling outbreak response | STAThttps://www.statnews.com/2025/04/14/cdc-hepatitis-lab-closes-rif-outbreak-response/
Hepatitis B is preventable, and hepatitis C is curable. […] The loss of the CDCs viral hepatitis lab will leave the country with no good way to measure the scale of the problem it faces with these diseases, they suggested, and less able to find the sources of and put an end to outbreaks that can be linked to contaminated food, in the case of hepatitis A, or poor infection control procedures in medical facilities, in the case of hepatitis B and C. […] One of the key hurdles in preventing transmission of these viruses is that many people who are infected do not know it. […] There is no cure for hepatitis B, though there is an effective vaccine, which is supposed to be given to newborns to prevent infection at birth. […] The closure also comes as the lab was making big strides in developing a point-of-care test for hepatitis C, something that has long been needed and does not exist anywhere in the world. […] Testing for hepatitis C is currently a two-step process. A single blood draw that could determine on the spot whether a person is infected would be a game-changer, especially now that there are direct-acting antiviral pills that are effectively a cure.
- #2 Prevention of Perinatal Hepatitis B Virus Transmissionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC4164184/
Hepatitis B virus (HBV) infection, the most common form of chronic hepatitis worldwide, is a major public health problem affecting an estimated 360 million people globally. […] Screening pregnant women for HBV infection, providing infant postexposure prophylaxis, and maternal treatment with antiviral medications are strategies for reducing MTCT transmission rates and the global burden of new chronic HBV infections. […] Administration of hepatitis B immune globulin (HBIG) and hepatitis B (HepB) vaccine within 24 hours of birth, followed by completion of the vaccine series, is 85%95% efficacious for prevention of MTCT. […] The Advisory Committee on Immunization Practices (ACIP) recommends screening pregnant women (including women previously vaccinated or previously tested) for HBsAg during the first prenatal visit of each pregnancy.
- #2 Health: HIV/STI/Viral Hepatitis: Perinatal Infection Prevention Programhttps://www.in.gov/health/hiv-std-viral-hepatitis/hiv-prevention/perinatal-infection-prevention-program/
The Perinatal Infection Prevention Program works to prevent mother-to-child transmission of hepatitis B, hepatitis C, HIV and congenital syphilis infections through surveillance, case management, education, prenatal testing and policy recommendations. Some infections before and during pregnancy can be transmitted to the newborn during the birthing process. […] All pregnant women should be tested for hepatitis B surface antigen (HBsAg) at an early prenatal visit during each pregnancy. […] Perinatal HBV transmission can be prevented by identifying HBsAg-positive pregnant women and providing hepatitis B immune globulin (HBIG) and hepatitis B vaccine to their infants within 12 hours of birth, followed by the completion of the accelerated hepatitis B vaccine series at (0, 1 and 6 months for single-antigen) or (0, 2, 4, 6 months for combination vaccines).
- #2 Prophylaxis for Infants of Mothers with Hepatitis B | AAFPhttps://www.aafp.org/pubs/afp/issues/2003/0801/p544.html
Vertical transmission of hepatitis B virus (HBV) from mother to infant during birth is highly efficient. Without prophylaxis, about 30 percent of infants infected with HBV at birth will become chronically infected, placing them at increased risk of liver failure and death. […] Postexposure prophylaxis consists of administration of 0.5 mL of hepatitis B immunoglobulin (HBIG) and one dose of hepatitis B vaccine (HepB) given intramuscularly at separate sites within 12 hours of birth, followed by two additional doses of HepB given at one to two months and six months of age. This prophylaxis prevents HBV infection in 85 to 95 percent of infants. […] The authors conclude that a public-health based surveillance system improves postexposure immunoprophylaxis and postvaccination serotesting rates; however, many children do not complete the vaccination regimen or receive serotesting. With full vaccination, protective levels of anti-HBs are achieved in 91 percent of children, and additional doses after nonprotective serotest results can increase this rate to 98 percent, decreasing the eventual HBs Ag-positive rate to around 2 percent. Postprophylaxis serotesting is best performed within three to four months after receipt of the third dose of vaccine. Infants in the lowest income families (less than $15,000 annual household income) are at the greatest risk for inadequate levels of antibodies.
- #2 Preventionhttps://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hepatitis/prevention
The essential package of viral hepatitis prevention services contributes to broader health outcomes and should include: vaccination, particularly for HBV, and where appropriate HAV and HEV (a HEV vaccine has been developed and licensed in China, but is not yet widely available); injection, blood and surgical safety and universal precautions; prevention of mother-to-child transmission of HBV; harm reduction services for people who inject drugs; and treatment of chronic HBV and HCV infection as secondary and tertiary prevention. […] In addition, ensuring high levels of sanitation and access to safe food and water are essential to prevent and control epidemics of HAV and HEV. Interventions to prevent sexual transmission of HBV and HCV are also important for specific populations. […] Prevent infection among infants – for a hepatitis free future All newborns should be vaccinated against hepatitis B at birth, followed by at least 2 additional doses.
- #2 Virginia Perinatal Hepatitis B Prevention (VPHBP) Program – Immunizationhttps://www.vdh.virginia.gov/immunization/vphbp/
Tracking contacts and infants of HBsAg positive pregnant women to ensure that appropriate treatment is received, thereby eliminating the transmission of perinatal hepatitis B. […] Free prevaccination testing for sexual partners and household contacts of the HBsAg positive pregnant woman and free hepatitis B (HB) vaccine for all susceptible partners and contacts. Free post vaccine testing of sexual partners. The local health departments, upon referral from the VPHBP Program, provide these services. […] Hepatitis B Immune Globulin and HB vaccine are provided at no charge to delivery hospitals. […] Free post vaccination testing for infants 3-9 months after completion of the HB vaccine series to ensure protection against HBV.
- #2 Hepatitis B Post-Exposure Treatmenthttps://www.hepb.org/prevention-and-diagnosis/post-exposure-treatment/
If an uninfected, unvaccinated person – or anyone who does not know their hepatitis B status – is exposed to the hepatitis B virus through contact with infected blood, a timely postexposure prophylaxis (PEP) can prevent an infection and subsequent development of a chronic infection or liver disease. […] Any person who is uninfected/unvaccinated or does not know their hepatitis B status should receive postexposure prophylaxis after contact with potentially infected blood. […] Neither pregnancy nor breastfeeding should be considered a contraindication to administration of the hepatitis B vaccination and HBIG to women.
- #2 Hepatitis A virus infection: Treatment and prevention – UpToDatehttps://www.uptodate.com/contents/hepatitis-a-virus-infection-treatment-and-prevention
The World Health Organization (WHO) has stated that whether or not to include the vaccine in routine childhood immunizations depends on the local context. […] The primary tool for protection against hepatitis A prior to exposure is vaccination, which is superior to immune globulin with respect to achievable antibody concentrations and durability of immune response. […] Immune globulin can decrease the incidence of HAV infection by more than 90 percent. […] Individuals who warrant postexposure protection (ie, hepatitis A vaccine and/or immune globulin) after exposure to HAV include close personal contacts of an individual with laboratory-confirmed HAV infection, childcare center contacts, and food handlers. […] The approach to HAV postexposure prophylaxis is as follows: For individuals with recent HAV exposure who have not previously received HAV vaccine, postexposure prophylaxis should be administered with either a single dose of single-antigen HAV vaccine or immune globulin as soon as possible, within two weeks of exposure. […] Hygienic practices for prevention of HAV infection include handwashing, avoiding tap water and raw foods in areas with poor sanitation, and heating foods appropriately.
- #2 Hepatitis B exposure – post exposure prophylaxis (PEP) | SA Healthhttps://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/clinical+programs+and+practice+guidelines/infectious+disease+control/hepatitis+b+exposure+pep/hepatitis+b+exposure+post+exposure+prophylaxis+pep
Hepatitis B is a serious viral infection that causes inflammation of the liver. […] After possible exposure to the hepatitis B virus, hepatitis B post-exposure prophylaxis (PEP) can be used to decrease the chance of getting hepatitis B. […] Hepatitis B PEP must be given within 72 hours, though it is most effective if given as early as possible. […] Hepatitis B PEP is available from hospital emergency departments, although you may be able to get it through your workplace if your exposure was at work. […] Hepatitis B vaccination is recommended as part of the routine vaccinations for infants. Hepatitis B vaccination is also available free for people at higher risk of getting hepatitis B and recommended for people at higher risk of severe disease. […] In Australia, women who are pregnant are routinely tested for hepatitis B. If the mother has hepatitis B, her baby should be given hepatitis B PEP within 24 hours of birth.
- #2 Hepatitis B disease info and PEP treatment | HyperHEP® S/Dhttps://www.hyperhepb.com/en/hcp/hepatitis-b
Postexposure Prophylaxis for Hepatitis B […] HyperHEP B contains high titers of hepatitis B antibodies for postexposure prophylaxis (PEP), providing rapid immune protection with detectable levels of antibodies that persist for approximately 2 months or longer. When used in combination with hepatitis B vaccine, a hepatitis B immune globulin such as HyperHEP B offers maximum postexposure immune protection. […] For individuals who have been exposed to hepatitis B, the Centers for Disease Control and Prevention (CDC) recommends PEP within approximately 24 hours. […] Prophylaxis Following Percutaneous or Permucosal Exposure […] Hepatitis B immune globulin (human)x1 immediately* […] Initiate HB Vaccine series […] For persons who refuse hepatitis B vaccine, a second dose of hepatitis B immune globulin (human) should be given 1 month after the first dose.
- #2 Prevention of Hepatitis B Reactivation During Immunosuppressive Therapy Hepatitis B – Viral Hepatitis and Liver Diseasehttps://www.hepatitis.va.gov/hbv/reactivation-prevention.asp
Test all patients for HBsAg, HBsAb, and HBcAb Total (IgG) (if not done in the last 6 months). […] Immunize for HBV if the patient is not exposed (HbcAb is negative) nor immune (HBcAB and HBsAb are both negative). Note, immunizations may be effective if given less than 4 weeks prior to a B cell depleting agent such as Rituximab and may need to be offered 6 months after completion of therapy. […] If the HBsAg and/or HBcAb (Total) is detectable, order tests for hepatitis B viral load (HBV-DNA) and ALT and consider additional factors for risk determination: […] If the HBV DNA is detectable, or if there is evidence of advanced liver disease, refer the patient to a hepatology or infectious disease specialist for evaluation. Chemotherapy for cancer should not be delayed and HBV antiviral prophylaxis can be initiated until a risk assessment is completed. […] If the patient is high or moderate risk, refer to Table 3: HBV Antiviral Medication Options for reactivation prophylaxis.
- #2 New AGA Guidelines Recommend Risk-Based Prophylaxis for Hepatitis B Reactivation Monitoringhttps://www.ajmc.com/view/new-aga-guidelines-recommend-risk-based-prophylaxis-for-hepatitis-b-reactivation-monitoring
Patients potentially at risk of HBVr: Hepatitis B testing is recommended for all individuals at potential risk, in line with CDC screening guidelines for all adults aged 18 years and over. […] While the 2015 guidelines emphasized prophylaxis for high-risk patients, the updated recommendations encouraged a broader consideration of antiviral prophylaxis, particularly for those with a history of HBV infection or high-risk factors. […] The authors of the updated guidelines recognized that not all patients need immediate antiviral treatment and offer more refined recommendations for monitoring lower-risk individuals, enabling personalized, risk-based management. […] Additionally, they highlighted the role of national registries and online tools in improving risk estimation and clinical decision-making, emphasizing technology as a key area for future development.
- #2 Hepatitis B virus prophylaxis in immunocompromised adultshttps://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/prophylaxis-and-treatment/1382-hepatitis-b-virus-prophylaxis-in-immunocompro
Recommendations […] Antiviral prophylaxis with a potent, high barrier to resistance nucleoside/nucleotide analogues (i.e. entecavir or tenofovir) is recommended over lamivudine. […] Antiviral prophylaxis is recommended for all HBsAg positive patients with haematological malignancy or solid tumour undergoing therapy. […] In patients who are HBsAg negative and anti-HBc positive the cancer therapy regimen determines the risk for HBV reactivation. […] Antiviral prophylaxis with a nucleoside/nucleotide analogue should be continued post cessation of therapy for: 18 to 24 months in patients who received higher risk cancer therapy. […] Recommendations on the duration of antiviral prophylaxis differ across international guidelines, ranging from 6 to 12 months after the cessation of chemotherapy, and for 12 to 24 months after the cessation of anti-CD20 monoclonal antibodies or BMT to reduce the risk of HBV reactivation which may occur after the withdrawal of antiviral therapy. […] Immunisation against hepatitis B is recommended for patients who are HBV naive and BMT donors. […] Entecavir or tenofovir is recommended as first-line antiviral therapy and should be initiated as soon as possible relative to the start of anti-cancer therapy. […] During antiviral prophylaxis, ALT and HBV DNA levels should be monitored every 3 months. […] Testing for HBV DNA, ALT and HBsAg is recommended every 3 months for a minimum of 12 months after cessation of antiviral prophylaxis to monitor for an increase in HBV DNA levels.
- #2 Prevention of Perinatal Hepatitis B Virus Transmissionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC4164184/
A meta-analysis evaluating 37 randomized control trials (RCTs) in the Chinese and English literature suggests multiple small doses of HBIG in late pregnancy combined with PEP after birth can reduce MTCT. […] The most extensive published experience is with lamivudine, a reverse-transcriptase nucleoside analog inhibitor with activity against HBV replication. […] Tenofovir disoproxil fumarate (TDF) is a potent nucleotide analog reverse-transcriptase inhibitor. It is considered safe and efficacious with no reported HBV resistance based on studies in HIV, HBV, and HIV/HBV coinfected women.
- #2 Preventing Hepatitis | NYU Langone Healthhttps://nyulangone.org/conditions/hepatitis/prevention
If you plan to travel to a country where hepatitis A is common and you were not vaccinated already, which most likely occurred when you were a baby, NYU Langone doctors strongly recommend getting a hepatitis A vaccine before you go. […] Hepatitis B vaccination is available to all. […] If you plan to travel to a country where hepatitis B is common, doctors recommend starting the vaccination process at least six months beforehand to ensure full protection. […] Ensuring good hygiene and avoiding contact with contaminated objects or bodily fluids can protect against infection by any of the hepatitis viruses. […] Practicing safe sex can help prevent infection. […] The best prevention is to avoid sharing needles, which can transfer small amounts of blood from one person to another. […] You can reduce your risk of hepatitis D by practicing safe sex. […] To reduce your risk of infection, doctors recommend drinking bottled water when traveling in countries where hepatitis E is common and avoiding tap water when brushing your teeth, making ice, and rinsing fruits and vegetables.
- #2 Viral Hepatitis – Disease Preventionhttps://www.vdh.virginia.gov/disease-prevention/disease-prevention/viral-hepatitis/
Frequent hand washing with soap and water can help prevent the spread of hepatitis A. […] The best way to prevent hepatitis A is to get vaccinated. Vaccination is recommended for all children, for travelers to certain countries, and for people at high risk for infection. […] The best way to prevent hepatitis B is by getting the hepatitis B vaccine. The hepatitis B vaccine is safe and effective and is usually given as 3 shots over a 6-month period. […] The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease. One of the main behaviors that leads to hepatitis C is injecting drugs.
- #2 Hepatitis B: Prevention and risks – Canada.cahttps://www.canada.ca/en/public-health/services/diseases/hepatitis-b/prevention-risks.html
Hepatitis B is preventable through immunization. Ask your health care provider to check if you are protected against hepatitis B (either through vaccination or previous infection). Consider getting the vaccine if you are not protected and/or have an increased likelihood of getting hepatitis B. […] To help prevent acquiring or transmitting HBV: talk to your partner(s) about safer sex and being tested for sexually transmitted and blood borne infections (STBBI) […] learn about safer sex methods and practice them, such as correctly and consistently using a condom during vaginal, anal and oral sex […] use new drug use equipment and do not share equipment for preparing and injecting, smoking or snorting drugs […] assure household members are protected […] only get tattoos and piercings in professional settings that follow regulations and standards and are inspected and approved by local public health departments.
- #2 Hepatitis – PAHO/WHO | Pan American Health Organizationhttps://www.paho.org/en/topics/hepatitis
More than half of the countries in the Americas (57%) have national strategies or plans for prevention, treatment and control of viral hepatitis. […] Birth dose vaccination during the first 24 hours is key to prevent HBV mother to child transmission and routine infant vaccination is the cornerstone for achieving population-based immunity to HBV to prevent transmission among all age groups. […] In the Americas, the Member States of the Pan American Health Organization (PAHO) approved a Plan of Action for the Prevention and Control of Viral Hepatitis 2016-2019 to catalyze public health efforts for preventing and controlling viral hepatitis, with emphasis on hepatitis B and C. […] The regional plan is aligned with the WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021, which was approved by the 69th WHA in May 2016.
- #2 Hepatitis Plan | Department of Health | Commonwealth of Pennsylvaniahttps://www.pa.gov/agencies/health/diseases-conditions/infectious-disease/hepatitis/hepatitis-plan.html
In 2021, DOH piloted listening session opportunities for people affected by viral hepatitis to share their experience navigating the disease in Pennsylvania. […] DOH needs to improve awareness around viral hepatitis prevention, diagnosis, and treatment and expand syringe service programs. […] Long-term Goal 1: Raise public awareness of viral hepatitis prevention and education as a statewide priority. […] Expand hepatitis vaccine coverage and education, particularly among high-risk adults. […] Improve access to sterile syringes and other injection equipment for viral hepatitis prevention by supporting statewide harm reduction service expansion. […] Ensure that people receiving viral hepatitis education and prevention interventions also have access to overdose prevention and treatment for substance use disorder.
- #2 ECDC | Prevention of hepatitis B and C in the EU/EEA. | Homehttps://www.ecdc.europa.eu/assets/Prevention-Hepatitis-B-and-C/index.html
There has been a decline in the reported number of new transmissions of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections across the European Union (EU) and European Economic Area (EEA), but there remain approximately six million people living with chronic HBV or HCV infection. […] Based on available data, progress across the EU/EEA region is variable but overall many countries are far from reaching the 2020 WHO European Action Plan hepatitis prevention targets, and a strengthening of hepatitis prevention programmes is needed. […] The hepatitis B vaccine is an important tool for hepatitis B prevention, but only 50% of EU/EEA countries with universal childhood vaccination have reached the target of 95% hepatitis B vaccination coverage. […] Countries employ different approaches to help prevent vertical transmission of hepatitis B, including antenatal screening and HBV vaccine birth doses.
- #2 Prevention of hepatitis B and C in the EU/EEA, 2024https://www.ecdc.europa.eu/en/publications-data/prevention-hepatitis-b-and-c-eueea-2024
Countries employ different approaches to help prevent vertical transmission of hepatitis B, including antenatal screening and HBV vaccine birth doses. Data on coverage of these programmes are limited, however they do indicate that most reporting countries achieved the targets for coverage of antenatal screening and hepatitis B vaccine birth dose. […] Data on hepatitis B vaccination programmes aimed at healthcare workers, people in prison and PWID are limited. Available data suggest that countries should expand their adult hepatitis B vaccination coverage, especially for populations at risk. […] While all EU/EEA countries screen blood donations for HBV and HCV, only 14 countries reported screening 100% of blood donations for HBV and HCV using nucleic acid testing (NAT). […] Sterile needle and syringe distribution and opioid agonist treatment (OAT) are effective ways of reducing the transmission of hepatitis B and C. However, although data are lacking from many countries, only four have reached the targets for both of these programmes, suggesting a significant need to strengthen harm reduction programmes focussing on PWID.
- #2 Viral Hepatitis National Strategic Plan Overview | HHS.govLockhttps://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html
Aims to increase uptake of hepatitis vaccination among populations for whom vaccination is recommended, increase access to harm reduction services, substance use treatment and peer navigation and utilize a treatment as prevention approach […] Seeks to implement universal hepatitis C screening guidelines, hepatitis B testing, and linkage to care in a range of settings and expand the capacity of the public health and provider workforce to provide viral hepatitis prevention, testing, care and treatment services […] Seeks to implement strategies and promote policies to enhance collaborative, integrated, patient-centered models of care […] Focuses on opportunities to expand research and development of a hepatitis C vaccine, point of care testing and improved diagnostics and therapeutics. The Plan also focuses on implementation research to put into practice evidence-based interventions, as effective interventions to improve prevention, testing and treatment are identified […] Aims to improve viral hepatitis surveillance data collection, management, and analysis, including interoperability of data and data sharing, to understand the true scope, level of public health threat, and opportunities to address viral hepatitis.
- #2 Viral Hepatitis Prevention and Surveillance VLC | NASTADhttps://nastad.org/hepatitis-vlc
Improving provider awareness and capacity to increase viral hepatitis testing and treatment. […] Establishing partnerships in settings (clinical, behavioral and laboratory) that conduct high volume of viral hepatitis testing to improve reporting and data quality. […] Improving capacity of PH labs and clinics to conduct all VH testing and report results electronically to HDs. […] Removing restrictions on access to hepatitis treatment. […] Establishing and conducting surveillance and case management for perinatal HCV among pregnant persons.
- #3 HIV and Viral Hepatitis Prevention and Treatment Resources in Texas | Texas DSHShttps://www.dshs.texas.gov/hivstd/reports/hepatitis-c/resources
Hepatitis prevention […] Hepatitis prevention includes CDC funding for viral hepatitis coordination given to DSHS and the City of Houston. Local funds from the City of Houston. SAMHSA funding for hepatitis prevention services. […] The best method of preventing infection from hepatitis B is vaccination. […] Texas law requires that providers and hospitals screen all pregnant women for HBsAg at their first prenatal visit and at delivery. […] There is no vaccine to prevent Hepatitis C virus (HCV) infection. Prevention efforts rely on risk assessment, HCV testing, referrals to treatment for those with HCV, and health education.
- #3 Hepatitis B disease info and PEP treatment | HyperHEP® S/Dhttps://www.hyperhepb.com/en/hcp/hepatitis-b
Prophylaxis of Infants Born to HBsAg- and HBeAg-Positive Mothers […] Efficacy of prophylactic hepatitis B immune globulin (human) (HBIG) in infants at risk depends on administering HBIG on the day of birth. It is therefore vital that HBsAg-positive mothers be identified before delivery. […] HBIG administered at birth should not interfere with oral polio and diphtheria-tetanus-pertussis vaccines administered at 2 months of age. […] Hepatitis B immune globulin (human) (0.5 mL) should be administered intramuscularly to the newborn infant after physiologic stabilization of the infant and preferably within 12 hours of birth. Hepatitis B immune globulin (human) efficacy decreases markedly if treatment is delayed beyond 48 hours. […] Prophylaxis for Sexual Exposure to Hepatitis B
- #3 Hepatitis B disease info and PEP treatment | HyperHEP® S/Dhttps://www.hyperhepb.com/en/hcp/hepatitis-b
Postexposure Prophylaxis for Hepatitis B […] HyperHEP B contains high titers of hepatitis B antibodies for postexposure prophylaxis (PEP), providing rapid immune protection with detectable levels of antibodies that persist for approximately 2 months or longer. When used in combination with hepatitis B vaccine, a hepatitis B immune globulin such as HyperHEP B offers maximum postexposure immune protection. […] For individuals who have been exposed to hepatitis B, the Centers for Disease Control and Prevention (CDC) recommends PEP within approximately 24 hours. […] Prophylaxis Following Percutaneous or Permucosal Exposure […] Hepatitis B immune globulin (human)x1 immediately* […] Initiate HB Vaccine series […] For persons who refuse hepatitis B vaccine, a second dose of hepatitis B immune globulin (human) should be given 1 month after the first dose.
- #3 Hepatitis B virus prophylaxis in immunocompromised adultshttps://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/prophylaxis-and-treatment/1382-hepatitis-b-virus-prophylaxis-in-immunocompro
Recommendations […] Antiviral prophylaxis with a potent, high barrier to resistance nucleoside/nucleotide analogues (i.e. entecavir or tenofovir) is recommended over lamivudine. […] Antiviral prophylaxis is recommended for all HBsAg positive patients with haematological malignancy or solid tumour undergoing therapy. […] In patients who are HBsAg negative and anti-HBc positive the cancer therapy regimen determines the risk for HBV reactivation. […] Antiviral prophylaxis with a nucleoside/nucleotide analogue should be continued post cessation of therapy for: 18 to 24 months in patients who received higher risk cancer therapy. […] Recommendations on the duration of antiviral prophylaxis differ across international guidelines, ranging from 6 to 12 months after the cessation of chemotherapy, and for 12 to 24 months after the cessation of anti-CD20 monoclonal antibodies or BMT to reduce the risk of HBV reactivation which may occur after the withdrawal of antiviral therapy. […] Immunisation against hepatitis B is recommended for patients who are HBV naive and BMT donors. […] Entecavir or tenofovir is recommended as first-line antiviral therapy and should be initiated as soon as possible relative to the start of anti-cancer therapy. […] During antiviral prophylaxis, ALT and HBV DNA levels should be monitored every 3 months. […] Testing for HBV DNA, ALT and HBsAg is recommended every 3 months for a minimum of 12 months after cessation of antiviral prophylaxis to monitor for an increase in HBV DNA levels.
- #3https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B can be prevented by vaccines that are safe, available and effective. […] Hepatitis B can be prevented with a safe and effective vaccine. The vaccine is usually given soon after birth with boosters a few weeks later. It offers nearly 100% protection against the virus. […] Hepatitis B is preventable with a vaccine. All babies should receive the hepatitis B vaccine as soon as possible after birth (within 24 hours). This is followed by two or three doses of hepatitis B vaccine at least four weeks apart. […] Hepatitis B can be passed from mother to child. This can be prevented by taking antiviral medicines to prevent transmission, in addition to the vaccine. […] To reduce the risk of getting or spreading hepatitis B: practice safe sex by using condoms and reducing the number of sexual partners; avoid sharing needles or any equipment used for injecting drugs, piercing, or tattooing; wash your hands thoroughly with soap and water after coming into contact with blood, body fluids, or contaminated surfaces; get a hepatitis B vaccine if working in a healthcare setting.
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