Combined

hepatitis A Hepatitis A is an infectious liver disease caused by Hepatitis A virus (HAV); it is a type of viral hepatitis. Many cases have few or no symptoms, especially in the young. The time between infection and symptoms, in those who develop them, is ...

and B vaccine, is used to provide protection against

and

hepatitis B Hepatitis B is an infectious disease caused by the '' hepatitis B virus'' (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection. Many people have no symptoms during an initial infection. ...

. It is given by injection into muscle. It is used in areas where hepatitis A and B are endemic, for travelers, people with

hepatitis C Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection period, people often have mild or no symptoms. Early symptoms can include ...

or chronic liver disease, and those at high risk of

sexually transmitted diseases A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral ...

. The combined vaccine is as safe and protective as if given as separate hepatitis A and B vaccines. It is generally well-tolerated. Common side effects are mild and include redness and pain at the injection site, where a small lump may appear. Feeling faint or tired, or a headache may occur. Other side effects include numbness, tingling, rash, bruising, abnormal bleeding such as from the nose or gums, weak muscle or pain. Severe side effects are rare and include an allergic reaction and seizures. It is widely available.

Administration schedule

Routine Twinrix vaccination is administered by intramuscular injection in the

deltoid Deltoid (delta-shaped) can refer to: * The deltoid muscle, a muscle in the shoulder * Kite (geometry), also known as a deltoid, a type of quadrilateral * A deltoid curve, a three-cusped hypocycloid * A leaf shape * The deltoid tuberosity, a part o ...

area using a schedule of three separate doses at 0, 1, and 6 months ( inimum intervals: 4 weeks between doses 1 and 2, 5 months between doses 2 and 3. In some circumstances, an accelerated dosing schedule of 0, 7 and 21 to 30 days followed by a booster at 12 months can be used and was shown to have similar efficacy as the traditional schedule.

Efficacy

The U.S.

Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency under the United S ...

(CDC) reports that clinical trials found the following levels of protection against Hepatitis A and Hepatitis B one month after each dose: :A: 93.8%, 98.8%, 99.9% :B: 30.8%, 78.2%, 98.5%

Availability

Twinrix is a brand manufactured by GlaxoSmithKline Biologicals. The full generic name is

inactivated &

( recombinant) vaccine. Twinrix is administered over three doses. The name was created because it is a mixture of two earlier vaccines — Havrix, an inactivated-virus

Hepatitis A vaccine Hepatitis A vaccine is a vaccine that prevents hepatitis A. It is effective in around 95% of cases and lasts for at least twenty years and possibly a person's entire life. If given, two doses are recommended beginning after the age of one. It ...

, and Engerix-B, a recombinant

Hepatitis B vaccine Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and ...

. Twinrix first entered the market in early 1997. In the United States, Twinrix is approved by the

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

(FDA) for those aged 18 and older. In some countries outside the United States, notably Canada and in the European Union, Twinrix is known as Twinrix Adult or Ambirix and a pediatric formulation, called Twinrix Junior or Twinrix Paediatric, is available.

Society and culture

Economics

By being a combination it may reduce administrative costs and achieve a better uptake of the vaccine.

Brand names

Brand names include Twinrix, Twinrix Junior, Twinrix paediatric, Ambirix, and Bilive.

References

{{Portal bar , Medicine , Viruses Combination vaccines Drugs developed by GSK plc Hepatitis A Hepatitis B Hepatitis vaccines sv:Hepatit#Vaccin