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Qu et al. Etiological prevention of liver cancer

Table 1: Summary of recommendations for HBV vaccinations
Setting Recommendation
Pregnancy Screening for HBsAg in the first trimester;
HBsAg-negative Receive three doses of HBV vaccine: the first dose to be given within 24 h after delivery, the
second and third doses to be given at 1 month and 6 months of age
Pregnancy Screening for HBsAg in the first trimester and determine the serum levels of HBV DNA;
HBsAg-positive Administration of 100 IU HBIG within 12 h after birth in combination with a full course of HBV
HBV DNA < 200,000 IU/mL vaccination. The administration dose is 10 μg vaccine from recombinant yeast or 20 μg vaccine from
Chinese hamster oocyte;
The vaccinated infants should be tested for the presence of HBsAg and the anti-HBs titer 1-2
month after completing the third dose of vaccine;
The fourth dose of HB vaccine should be given if he/she is seronegative for HBsAg and had anti-
HBs < 10 mIU/mL
Pregnancy Screening for HBsAg in the first trimester and determine the serum levels of HBV DNA. Antiviral
HBsAg-positive treatment is recommended;
HBV DNA > 200,000 IU/mL Antiviral therapy using tenofovir or telbivudine should start at week 24-28 of gestation to reduce the
risk of perinatal transmission of HBV;
For newborns: administration of 100 IU HBIG within 12 h after birth in combination with a full
course of HBV vaccination. The administration dose is 10 μg vaccine from recombinant yeast or 20
μg vaccine from Chinese hamster oocyte;
The vaccinated infants should be tested for the presence of HBsAg and the anti-HBs titer 1-2
month after completing the third dose of vaccine;
The fourth dose of HB vaccine should be given if he/she is seronegative for HBsAg and had anti-
HBs < 10 mIU/mL
For mothers, the antiviral therapy could be discontinued at birth to 1 month postpartum. With
discontinuation of treatment, women should be monitored for ALT flares every 3 months for 6
months
Vaccinated adolescents completed If born to HBsAg-positive mother, determine the HBsAg and anti-HBs levels. Receive the HBV
neonatal HBV vaccination series vaccine booster to generate anti-HBs > 10 mIU/mL;
without HBIG administration If born to HBsAg-negative mother, no HBV vaccine booster necessary in general setting
HBsAg: hepatitis B surface antigen; HBV: hepatitis B virus; HBIG: hepatitis B immunoglobulin

week 24-28 of gestation to reduce the risk of perinatal Authors’ contributions
transmission of HBV. The oral antiviral drugs currently Drafted the outline of this review: C. Qu
are pregnancy Class C (lamivudine, entecavir, and Drafted the parts regarding on the hepatitis B
adefovir dipivoxil) or Class B (telbivudine and tenofovir). immunization: C. Qu, K. Chen
Telbivudine or tenofovir is recommended based on the Drafted the parts regarding on the antiviral therapy
studies conducted in multiple medical centers and the to pregnant women and prevention of mother to child
recommendations from AASLD, EASL and APASL; (5) transmission: Z. Duan, H. Zou
for the mothers, antiviral therapy could be discontinued Finalized the manuscript: C. Qu
at delivery to 1 month postpartum. With discontinuation
of treatment, women should be monitored for ALT flares
every 3 months for 6 months; (6) for infants born to Financial support and sponsorship
HBsAg-positive mothers regardless of the serum HBV The study is supported by: State Key Projects Specialized
DNA levels, the administration of 100 IU HBIG within on Infectious Diseases, No. 2017ZX10201201-006-
003, to CQ; Key research projects for precision
12 h after birth should be combined with a full course medicine, No. 2017YFC0908103, to CQ; State Key
of HBV vaccination. The administration dose is 10 μg Projects Specialized on Infectious Diseases, No.
vaccine from recombinant yeast or 20 μg vaccine from 2017ZX10201201, to ZD; and Beijing Municipal Science
Chinese hamster oocyte. The vaccinated infants should & Technology Commission, No. Z151100003915096
be tested for the presence of HBsAg and the anti- and No. Z16110000516084, to HZ.
HBs titer 1-2 months after completing the third dose of
vaccine. If he/she is seronegative for HBsAg and has
anti-HBs < 10 mIU/mL, the fourth dose of HBV vaccine Conflicts of interest
should be given. The sponsors of the study had no role in study design,
data collection, data analysis, data interpretation, or
writing of the manuscript.The findings and conclusion
DECLARATIONS in this review do not represent the official position of
Chinese Center of Disease Control and Prevention.
Acknowledgments The official document can be found via the link of http://
We thank Dr. Mei-Sze Chua from Stanford University www.nhfpc.gov.cn/jkj/s3581/201701/a91fa2f3f9264cc1
for language polish of this manuscript. 86e1dee4b1f24084.shtml.

Hepatoma Research ¦ Volume 3 ¦ October 25, 2017 237