Hepatitis - Hepatitis B and D

To diagnose hepatitis D using an antibody test, hepatitis B must already have been identified.

Preventing Hepatitis B and its Transmission

General precautions for preventing hepatitis B when traveling are the same at those for hepatitis A. In infected people, preventing transmission are similar to those for hepatitis C.

Vaccinations for Prevention of Hepatitis B. Several inactivated virus vaccines, including Recombivax HB, GenHevac B, Hepagene, and Engerix-B, can prevent hepatitis B (HBV) and are safe even for infants and children. A triple-antigen hepatitis B vaccine (Hepacare) is proving to be effective for people who do not respond to the standard vaccines. Vaccination programs are also proving to reduce the risk for liver cancer. A combination vaccine (Twinrix) that contains Engerix-B and Havrix, a hepatitis A vaccine, is now approved for people with risk factors for both hepatitis A and B.

Click the icon to see an image discussing hepatitis B vaccine.

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Until recently, the vaccine contained a mercury-based preservative called thimerosal. In response to concerns, professional organizations recommended suspending vaccinations in infants with noninfected mothers. In September 1999, a thimerosal-free vaccine became available and medical centers are now urged to continue vaccinations. Unfortunately, even after the thimerosal-free vaccine became available, a number of hospitals still haven't restored vaccination of all infants. This is a safe vaccine and it is reducing the need for hospitalization in children. Parents should be sure their children are immunized.

Candidates for HBV Vaccinations. Experts now recommend that all infants and children not previously vaccinated be immunized by the time they reach seventh grade.

Typical schedules for hepatitis B vaccinations in childhood are as follows:

All infants should receive the hepatitis B vaccine soon after birth and before hospital discharge. (The first dose may also be given by age 2 months if the mother has no evidence of infection.) The second dose should be given at one to four months (at least four to six weeks after first dose); and the third between six and 18 months (at least 16 weeks after first dose and eight weeks after second dose). (A fourth dose may also be given as part of a combination vaccine.) This is a safe vaccine, even in newborns, and parents should be sure their infants are immunized.
Infants of mothers infected with HBV should be treated with immune globulin plus the hepatitis vaccine within 12 hours of birth. The second dose should be given at one to two months and the third at six months. Infants should be tested for antibody status at nine to 15 months to see if they are chronic virus carriers or need to be re-vaccinated.
When it is not known if a mother is infected or not, the infant should receive the vaccine within 12 hours of birth. The mother's blood should then be tested right away. If she is infected, the infant should receive immune globulin as soon as possible (no later than a week).
Children who are between 11 and 12 and who have not been immunized should receive two or three doses of the vaccine (depending on the brand) given over a few months.