Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Eur J Gastroenterol Hepatol. 2012 Dec;24(12):1363-9. doi: 10.1097/MEG.0b013e32835847c6.
Hepatitis B immune globulin (HBIG) injection during pregnancy and/or after birth is an intervention for preventing mother-to-child transmission of the hepatitis B (HB) virus. However, varying cost-effectiveness ratios among various HBIG therapies remain unclear. This study explored these differences in cost-effectiveness ratios.
Four districts in Wuhan, China, were selected for the current study using stratified random sampling. Pregnant women who were positive for HB surface antigen (HBsAg) and who received prenatal care in district-level maternal and child health hospitals were interviewed. The mothers and their children underwent follow-up visits from the time of pregnancy until the children were six-and-a-half months old.
A total of 324 cases completed the follow-up visits on a voluntary basis. Among the 324 HBsAg-positive pregnant women investigated, 60.49% (196/324) were injected with HBIG at different trimesters. A total of 249 neonates (76.85%) received an HBIG injection within 24 h after birth. The HBsAg-positive rate in infants was 5.56% (18/324). The HBIG-injected mother and infant group had the lowest chronic infection rate among children [odds ratio=0.14, 95% confidence interval (CI) 0.02-0.90, P=0.039]. The HBIG-injected infant group exhibited the lowest HBsAb-positive rate (odds ratio=0.07, 95% CI 0.02-0.23). The cost per averted disability-adjusted life years was lowest in the infant group: USD 118.61 (95% CI 105.23-131.99).
These results indicate that active and passive immunizations (HBIG and HB vaccine) entail the lowest cost in the prevention of chronic HB infection in infants. However, this programme has the lowest HBsAb-positive rate, which possibly prevents children from self-acquiring antibodies.
乙肝免疫球蛋白（HBIG）注射在妊娠期间和/或产后是预防乙型肝炎（HB）病毒母婴传播的干预措施。然而，不同 HBIG 治疗方法的成本效益比仍不清楚。本研究探讨了这些差异的成本效益比。
采用分层随机抽样，选择中国武汉的四个区进行本研究。对在区级妇幼保健院接受产前检查的乙肝表面抗原（HBsAg）阳性孕妇进行访谈。母亲及其子女从妊娠开始直至 6 个半月进行随访。
共有 324 例患者自愿完成随访。在调查的 324 例 HBsAg 阳性孕妇中，60.49%（196/324）在不同孕期注射了 HBIG。共有 249 名新生儿（76.85%）在出生后 24 小时内接受了 HBIG 注射。婴儿的 HBsAg 阳性率为 5.56%（18/324）。HBIG 注射母婴组儿童慢性感染率最低[比值比=0.14，95%置信区间（CI）0.02-0.90，P=0.039]。HBIG 注射婴儿组 HBsAb 阳性率最低[比值比=0.07，95%CI 0.02-0.23]。婴儿组每避免一个残疾调整生命年的成本最低：118.61 美元（95%CI 105.23-131.99）。
这些结果表明，主动和被动免疫（HBIG 和 HB 疫苗）在预防婴儿慢性 HB 感染方面的成本最低。然而，该方案 HBsAb 阳性率最低，这可能阻止儿童自身获得抗体。
