Hepatitis B is a viral infection that can cause both acute and chronic liver disease. It is estimated that 257 million people are living with hepatitis B, and in 2015 it resulted in 887,000 deaths mostly due to liver complications. Hepatitis B can be transmitted through bodily fluids, from mother to child during birth, sexually, or through blood or blood products. Prevention methods include screening blood donors, immunizing high risk groups with the hepatitis B vaccine through both active and passive immunization, and creating awareness about transmission. Treatment focuses on slowing liver disease progression and reducing cancer risk through antiviral medication. The global strategy aims to eliminate hepatitis B as a public health threat by increasing immunization and treatment rates.

1. Presenter: Nandan Prasad
CONTROL AND PREVENTION OF
HEPATITIS B
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2. Key facts
 Hepatitis B is a viral infection that
attacks the liver and can cause both acute
and chronic disease.
 An estimated 257 million people are
living with hepatitis B virus infection.
 In 2015, hepatitis B resulted in 887 000
deaths, mostly from complication.
 Hepatitis B is an important occupational
hazard for health workers.
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3. CHAIN OF TRANSMISSION
SOURCE/
RESERVOIR
MODE OF
TRANSMISSION
SUSCEPTIBLE
HOST
CASES CARRIERS
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4. MODES OF TRANSMISSION
 Parenteral route
 Perinatal transmission
 Sexual transmission
 Other routes – Horizontal transmission
INCUBATION PERIOD: 30 – 180 days
(avg: 75days)
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5. SUSCEPTIBLE HOST
 Healthcare workers
 People who frequently require blood or blood products,
dialysis patients, recipients of solid organ transplantations;
 Persons who inject drugs;
 Household and sexual contacts of people with chronic
HBV infection;
 People with multiple sexual partners.
 Travelers who have not completed their hepatitis B
vaccination series.
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6. WHY PREVENTION?
 The disease can be chronic.
 No specific treatment available.
 Fatal complications.- Hepatocellular Carcinoma
Cirrhosis of liver
 Significant economic burden.
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7. PREVENTION
GENERAL SPECIFIC
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8. GENERAL MEASURES
 Screening blood donors (NATIONAL BLOOD
POLICY 2002)
 Creating Awareness among
a)Healthcare Workers
b)Carriers
c)High risk individuals
 Following standard precautions.
 Screening of pregnant women.
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9. SPECIFIC
PREVENTION
ACTIVE
HEPATITIS B
VACCINE
PLASMA
DERIVED
RECOMBINANT
PASSIVE
HBIG
COMBINED
ACTIVE+PASSIVE
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10. HEPATITIS B VACCINE
 Recombinant vaccine
 Active substance – HBsAg
 Available as monovalent formulation or in fixed
combination with other vaccines.
 Contraindicated in allergic patients
 NOT CONTRAINDICATED in Pregnancy and
Lactation
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11. AGE DOSE SITE TYPE OF
FORMULATION
Birth 10mcg in
0.5mL
Anterolateral aspect of
thigh
monovalent
6weeks 10mcg in
0.5mL
Anterolateral aspect of
thigh
pentavalent
10weeks 10mcg in
0.5mL
Anterolateral aspect of
thigh
pentavalent
14weeks 10mcg in
0.5mL
Anterolateral aspect of
thigh
pentavalent
DOSAGE
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12. IMMUNISATION IN ADULTS(>20yrs)
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 Given to high risk individuals
 20mcg in 1mL suspension
 0,1,6 months
 SITE: Deltoid muscle
 Accelerated regimen: 0,1,3months

13. 13
GROUP Recombivax Engerix-B
Infants, children and adolescents
younger than 20 years of age
5mcg in 0.5mL 10mcg in
0.5mL
Adolescents 11–15 years (adult
formulation administered on 2-
dose schedule)
10mcg in 1mL -
Adults 20 years of age or older 10mcg in 1mL 20mcg in 1mL
Hemodialysis patients and other
immunocompromised persons
(adults 20 years or older)
40mcg in 1mL 40mcg in 2mL
TWINRIX – Hepatitis a & b given for people >18 yr old

14. PASSIVE IMMUNIZATION
 For immediate protection
 HBIG
 Given to those exposed to HBsAg positive blood
 Surgeons, nurses, lab workers
 Newborn infants of carrier mothers
 Sexual contacts of acute hepatitis b patients
 After liver transplant
 Should be given as soon as possible after an accidental
inoculation(6 – 48 hrs)
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15. DOSAGE
 Recommended dose – 0.05 to 0.07 ml/kg body weight
 2 doses i.m or i.v infusion
 30 days apart
 Provides short term passive protection for
approximately 3 months.
 Victim’s blood to be tested. Positive
Negative – Vaccination
to be started
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16. COMBINED IMMUNISATION
 Simultaneous administration of HBIG + Hepatitis B
vaccine.
 Ideal for
 Accidental exposure
 Newborn babies of carrier mothers
 HBIG – (0.05 – 0.07mL/kg body weight – within 24 hrs).
 Hepatitis B vaccine – 1.0mL(20mcg/1.0mL) – within 7
days of exposure – second and third doses given 1 and 6
months after 1st dose.
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17. TREATMENT
 No specific treatment available.
 GOALS OF TREATMENT
Slowing the progression of cirrhosis
Reduce incidence of liver cancer
 TENOFOVIR Suppress viral
 ENTECAVIR replication
 Lifelong treatment
 INTERFERONS
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18. Enhancing Surveillance
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 Provider education
 Case investigation
 Laboratory reporting
 Monitoring surveillance indicators
 Registries/databases for HBsAg-positive persons
 Hospital-based reporting

19. Global health sector strategy on viral
hepatitis 2016 - 2021
VISION
1. Eliminate viral hepatitis as a public health problem.
2. reduce new cases of chronic hepatitis by 90%
3. Reduce deaths due to viral hepatitis by 65%
BY THE YEAR 2030
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20. Key interventions
 PREVENTIVE:
1. 3 dose hepatitis b vaccine for infants
2. Prevention of mother-to-child transmission
3. Blood safety and injection safety
4. Harm reduction for persons who use drugs
 TREATMENT:
1. Diagnosis of HBV and HCV
2. Treatment of HBV and HCV
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21. SOURCE/
RESERVOIR
MODE OF
TRANSMISSION
SUSCEPTIBLE
HOST
CASES
•Screening blood donors
•Following aseptic
precaution
•Sterilization of
instruments
TREATMENT
AWARENESS-
1. Not to donate blood
2. Not to share razors, toothbrushes etc.
3. Use barrier methods of contraception
•Immunization
1. ACTIVE
2. PASSIVE
3. Passive-Active
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22. REFERENCES
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 Park’s Textbook Of Preventive And Social Medicine 24th
Edition M/s Banarsidas Bhanot Publishers
Page number – 225-232
 http://www.who.int/en/news-room/fact-
sheets/detail/hepatitis-b accessed on 20-09-2018
 https://wwwnc.cdc.gov/travel/yellowbook/2018/infectious-
diseases-related-to-travel/hepatitis-b
accessed on 20-09-2018
 https://www.cdc.gov/vaccines/pubs/surv-manual/chpt04-
hepb.html accessed on 20-09-2018

23. THANK YOU
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