High-Risk Groups for Hepatitis B Infection

The content discusses Hepatitis B infection and its high-risk groups, including those who practice unprotected sexual contact, share IV needles for drug use, or engage in gay/homosexual practices. It also highlights the importance of newborn vaccination against Hepatitis B, with a birth dose recommended to prevent 95% of future infections. The rationale for including a birth dose is to prevent infection and death in infants, especially those born to high-risk mothers.

Hepatitis B
Who are the high risk groups for hepatitis B infection?
There are general ways for spread of hepatitis B infection one via sexual contact i.e..,
seminal fluid, infected blood transfusion and contact with bodily fluid of infected person.[1]
The high risk groups are those who practise unprotected sexual contact with multiple sex
partners, sharing of intravenous (IV) needles for drug use.[4] Even those who involves in gay
(or) homosexual practise will easily get affected by hepatitis B infection, living with same
infected hepatitis infected person will spread disease for example if husband gets infected
definitely wife will get infected by hepatitis B. In addition new born infant is also prone to
infection as diseased mother breastfed milk will spread hepatitis B to children.[5] Not only
these risk factors even nurses working in healthcare institute are prone to hepatitis B infection
if protocols are not followed in nursing care more over frequent preventive measures / aid
helps nurses to overcome institutional infection.
The regions which are high prone to hepatitis B disease is Africa, Asia (central and
southeast) and Europe (eastern region).
What is the rationale for including a birth dose of hepatitis B vaccine in the NIP? Why
isn’t the birth dose restricted to infants of high risk mothers?
The right education of safe sex will prevent infection but the safe dose commonly
called as universal infant immunization is important and effective strategy to control hepatitis
B. Hence vaccination in first year of birth is important as three dose of hepatitis B is given at
interval of once a month to prevent 95% of future infection.[1] The birth dose (BCG,OPV) is
effective in prevention of hepatitis infection but it is advised not to dose mother who is found
to be an chronic carrier of hepatitis virus as it risks the infant survivability. In case of these

high risk mothers first dose should be given to new born within 24 hours period for
prevention of infection. Let’s consider if first dose is not given along with DTP to infant
which ultimately result in 5 % to 11% exposure of infants to chronic hepatitis within first six
months sometimes results in death.[3] The good tally of birth dose log is shown below,
[2]
If cold chain not maintained there is high risk of infection from dose itself am schematic view
of Vaccine Vail Monitor (VVM) is shown below,
[2]
References:
1. (Just M, 1988)
2. (Otto BF, 1999)

3. (Lewis E, 2001)
4. (Andre FE, 1944)
5. (Galazka A, 1998)