K. A. Attia et al. / Open Journal of Gastroenterology 3 (2013) 237-240
240
ble is HBV vaccine. Current vaccinal strategy must be
modified on the one hand starting immunization from
birth in all children whatever HBV status the mother has,
on the other hand, prescribing a nucleosidic analogs from
the 28th week to HBsAg-positive mothers who have
strong HBV viremia. So, even if children are systemati-
cally immunized at birth, searching for HBsAg in preg-
nant women must be made compulsory and quantify
HBV load in HBsAg-positive pregnant women in order
to identify those to whom a treatment through nucleosi-
dic analogs will be proposed for maximal reduction of
HBV infection perinatal transmission. Acquired immu-
nization through vaccination will allow to later prevent-
ing children from other HBV transmission risks, espe-
cially horizontal intrafamilial transmission.
5. CONCLUSION
Immunization coverage for children of our index subjects
was insufficient, especially before introduction of HBV
vaccine into the EVP. Outside vertical transmission,
those children were more exposed to HBV intrafamilial
transmission when they were not immunized against
HBV, when both parents were infected and when HBV
viremia of index subjects was higher than 2000 IU/ml.
Immunization coverage must therefore be improved, im-
munization must be started at birth and nucleosidic ana-
logs must be proposed to HBsAg-positive pregnant wo-
men with strong viremia.
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