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The importance of a preschool booster for children born to hepatitis B-positive mothers
  1. Shamez N Ladhani,
  2. Mary E Ramsay
  1. Immunisation Hepatitis and Blood Safety Department, Public Health England, London, UK
  1. Correspondence to Dr Mary E Ramsay, Immunisation Hepatitis and Blood Safety Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK; mary.ramsay{at}phe.gov.uk; Dr Shamez Ladhani, Immunisation Hepatitis and Blood Safety Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK; shamez.ladhani{at}phe.gov.uk

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Chronic hepatitis B virus (HBV) infection is associated with cirrhosis, hepatic failure and hepatocellular carcinoma in later life. The risk of developing chronic hepatitis is inversely related to age at infection, ranging from <10% in adults to >90% in babies born to mothers who are hepatitis B e-antigen-positive. WHO, therefore, recommends universal childhood hepatitis B immunisation commencing at birth.1

In the UK, endemic HBV transmission contributes to only a small proportion of new chronic infections, with most cases arising from immigration of established HBV carriers.2 Universal HBV vaccination, therefore, does not meet currently acceptable criteria for cost-effectiveness.3 Instead, a selective immunisation strategy targeting high-risk groups, including infants born to HBV-positive women, has been adopted.4 As part of this selective approach, the UK has historically recommended a booster dose for individuals at continued risk around 3–5 years after primary immunisation. Universal antenatal HBV screening was implemented in April 2000 and has consistently achieved high coverage rates …

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