A HEALTHY BOY IS BORN BY VAGINAL DELIVERY AT 40 WEEKS GESTATION. HIS MOTHER HAD CONFIRMED ACUTE HEPATITIS B DURING THIS PREGNANCY. WHICH PREVENTATIVE INTERVENTION SHOULD BE GIVEN IMMEDIATELY TO THE BABY?

• A. Confirm hepatitis B status of baby as first step
• B. Full course of hepatitis B vaccine
• C. Full course of hepatitis B vaccine and hepatitis B immunoglobulin ✓
• D. Hepatitis B immunoglobulin
• E. Hepatitis B vaccine as a single dose

In the scenario described, the baby is at risk of acquiring hepatitis B from the mother due to her confirmed acute hepatitis B infection during pregnancy. To prevent vertical transmission of hepatitis B from the mother to the newborn, immediate intervention is crucial. The recommended approach for a newborn born to a mother with acute hepatitis B is to administer both the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) as soon as possible after birth.

The rationale behind this recommendation is as follows:

1. Hepatitis B Vaccine: The hepatitis B vaccine contains a recombinant surface antigen of the hepatitis B virus. Administering the full course of the hepatitis B vaccine to the newborn provides active immunity against the virus. By stimulating the baby’s immune system to produce antibodies against the hepatitis B virus, the vaccine helps protect the infant from acquiring the infection.
2. Hepatitis B Immunoglobulin (HBIG): HBIG is a concentrated solution of antibodies that provide passive immunity against the hepatitis B virus. Administering HBIG along with the vaccine offers immediate protection to the newborn while their immune system responds to the vaccine and starts producing its antibodies. This dual approach of active vaccination and passive immunization significantly reduces the risk of vertical transmission of hepatitis B from an infected mother to her baby.
3. Timing: It is essential to administer both the hepatitis B vaccine and HBIG promptly after birth, preferably within 12 hours of delivery, to maximize their effectiveness in preventing transmission of the virus.
4. Follow-Up: Following the initial administration of HBIG and the first dose of the hepatitis B vaccine, additional doses of the vaccine will be required according to the standard vaccination schedule to ensure long-term immunity against hepatitis B.

In conclusion, in a scenario where a healthy baby is born to a mother with acute hepatitis B infection, immediate administration of both the full course of hepatitis B vaccine and HBIG is recommended to reduce the risk of vertical transmission and protect the newborn from acquiring hepatitis B.