With over 2 billion individuals having serological evidence of hepatitis B (HBV) infection worldwide and suboptimal treatment provided by current antiviral therapy, primary prevention through immunization remains the most effective way of controlling the spread of HBV [47].
Safe and effective vaccines against HBV infection have been available since 1982. Three classes of vaccine are available, produced in plasma, yeast, or mammalian cells. The vaccine prepared by concentrating and purifying plasma from hepatitis B surface antigen (HBsAg) carriers to produce subviral particles, although highly efficient and safe, is no longer used in most developed countries because of concerns for potential transmission of blood-borne infections. Yeast-derived recombinant HBV vaccines are produced by cloning the HBV S gene in yeast cells, and contain thiomersal as a preservative. Mammalian cell-derived recombinant vaccine, in addition to the S antigen, contain either antigens from the pre-S2 region or both the pre-S1 and pre-S2 regions that assemble into a virus-like particle and produce an enhanced immunologic response [48]. In 1991, the United States Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommended HBV vaccination for all infants, regardless of the HBsAg status of the mother [49]. HBV vaccine is usually given as three intramuscular doses over a 6-month period, with the first dose given at birth. This vaccination schedule decreased the burden of HBV disease in the U.S., a protective effect also noted in many other countries. These guidelines were updated in 2005 to recommend implementation of universal vaccination of neonates before discharge from the hospital [50].
With over 2 billion individuals having serological evidence of hepatitis B (HBV) infection worldwide and suboptimal treatment provided by current antiviral therapy, primary prevention through immunization remains the most effective way of controlling the spread of HBV [47].Safe and effective vaccines against HBV infection have been available since 1982. Three classes of vaccine are available, produced in plasma, yeast, or mammalian cells. The vaccine prepared by concentrating and purifying plasma from hepatitis B surface antigen (HBsAg) carriers to produce subviral particles, although highly efficient and safe, is no longer used in most developed countries because of concerns for potential transmission of blood-borne infections. Yeast-derived recombinant HBV vaccines are produced by cloning the HBV S gene in yeast cells, and contain thiomersal as a preservative. Mammalian cell-derived recombinant vaccine, in addition to the S antigen, contain either antigens from the pre-S2 region or both the pre-S1 and pre-S2 regions that assemble into a virus-like particle and produce an enhanced immunologic response [48]. In 1991, the United States Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommended HBV vaccination for all infants, regardless of the HBsAg status of the mother [49]. HBV vaccine is usually given as three intramuscular doses over a 6-month period, with the first dose given at birth. This vaccination schedule decreased the burden of HBV disease in the U.S., a protective effect also noted in many other countries. These guidelines were updated in 2005 to recommend implementation of universal vaccination of neonates before discharge from the hospital [50].
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