Hepatitis B control in Europe concentrates on antenatal screening to reduce vertical transmission.
In an attempt to reduce horizontal transmission and the pool of infectious individuals, the health authorities in Amsterdam integrated the tracing and immunizing of contacts in the antenatal screening program.
In this study, researchers from the Netherlands evaluated this public health program between 1992 and 1999.
In the program, all contacts are tested for serological markers of previous infection. Vaccination is offered to susceptible contacts.
In addition, chronically infected contacts are counseled and referred for treatment if justified.
|94% of contacts completed the vaccination series.|
|Journal of Hepatology|
Overall, the researchers found that for 738 women testing positive for the hepatitis B surface antigen, 1219 contacts were reported.
Of the 1219 contacts, 90% participated. The team found that 43% had serological markers of previous infection and of these, 25% were infectious.
There were 603 eligible contacts. Of these, 94% completed the vaccination series.
The research team determined that country of origin was an independent predictor of contact participation and compliance with completion of the vaccination series.
They found that postvaccination titers for antibodies against the surface antigen were below 10IU/L in 5% of contacts under 30 and in 12% of those over 30.
Dr Jim van Steenbergen and colleagues concluded, "Tracing and immunizing susceptible contacts of women screened as HBsAg-positive, should be an integral component of any country's HBV control program".