Hepatitis B
October 7, 2010 | 10,00 EUR | answered by Dr. med. Ralf Berg
My new partner has had chronic Hepatitis B since birth. Despite having a small amount of virus in her blood, she is a carrier of the disease.
I have now received the first injection for the Hepatitis B vaccine (active vaccination). In addition, my doctor has also given me a passive vaccination with Hepatitis B immunoglobulins.
He said that this prevents any transmission of Hepatitis B, even through sexual intercourse, as the passive vaccination provides defenses in the body until the active Hepatitis B vaccination takes effect.
Is a passive vaccination with Hepatitis B immunoglobulins really that safe?
Thank you for your response.
Hello, this is an interesting question in several ways.
1. Data:
I assume that you have received Hepatitis B immunoglobulin from Behring. Protection against infection is assumed if at least an AntiHBs titer in the blood of over 1:100 can be measured through this (or through active vaccination). There is no data on how long this titer of immunoglobulins lasts in an otherwise healthy organism after a single dose !! This ultimately means that this titer must be regularly monitored. The intervals for monitoring are also not scientifically supported, as there is no available data. The company recommends at least every 4 weeks.
The only data on the repetition of immunoglobulin administration exists only in liver transplant recipients with Hepatitis B infection. The antibody titer from the injection lasts at least 3 months. But be cautious, these are not "normal" comparison patients, as they are also immunosuppressed. These data cannot simply be transferred to your case.
2. Financial aspects:
The one-time passive administration costs 180 euros and is definitely not covered by statutory health insurance in your case. The same applies to the necessary titer determinations, which also cost around 60-80 euros per examination. Do you want to spend that much money?
3. Alternatives:
Until the active proof of an active vaccination titer (e.g. 1 week after the 3rd vaccination), abstinence is an option. This is incidentally the only 100% secure option. The second best (but not 100% foolproof) is simply using a condom, which is also cost-effective. The greatest uncertainty exists in the current method, at least until a titer proof is present in your blood.
In adults with Hepatitis B, there are cases of non-responder to the active vaccination. Therefore, titer determination is provided for professionally exposed individuals by BGs and the RKI. (BG=Trade associations, RKI=Robert Koch Institute)
I hope you have been able to follow the somewhat complicated explanations so far.
Since both vaccinations have already been administered, my final advice to both of you is:
In any case, complete the active vaccination (if possible on an accelerated schedule) and:
Option 1:
I would recommend having a hepatitis titer determination done at 4 and 8 weeks (even at your own expense) to ensure that you can have unprotected sex with certainty.
Option 2:
Alternatively, you could protect yourself with condoms until the second vaccination. If the titer determination is high enough for protection after another 4 weeks following the 2nd vaccination, you can then stop using condoms. It can be assumed that the active vaccination has been successful. For safety, one should observe the decrease in titer (which normally occurs very slowly after the 3rd vaccination, providing protection for over 10 years).
Best regards, Dr. R. Berg
