Hepatitis B immunization program in Taiwan associated with reduction in chronic liver disease deaths

"Hepatitis B virus (HBV) infection causes infant fulminant hepatitis (IFH), and chronic HBV infection may progress to chronic liver disease (CLD) and hepatocellular carcinoma (HCC). Taiwan launched a nationwide HBV immunization program for newborns in July 1984, which has successfully lowered the prevalence of chronic HBV carriers, incidence of HCC, and mortality of IFH in vaccinated birth cohorts. The mortality of CLD before and after HBV immunization has never been examined," write Chun-Ju Chiang, Ph.D., of National Taiwan University, Taipei, and colleagues.

As reported in a Research Letter, the authors assessed the 30-year outcomes of the immunization program. From July 1984 to June 1986, the immunization program covered only newborns with high- who were seropositive for HBV surface antigen. Coverage was extended to all newborns in July 1986, preschool children in July 1987, and primary school children in 1988-1990. Recombinant HBV vaccines replaced plasma-derived vaccines in 1992. The immunization coverage rates for birth cohorts from 1984 to 2010 was 88.8 percent to 96.9 percent. The mortality of IFH, CLD, and HCC and the incidence of HCC were compared among birth cohorts born before and after the launch of the program.

The researchers found that from 1977-1980 to 2001-2004, the age- and sex-adjusted rate ratios for individuals 5 to 29 years of age decreased by more than 90 percent for CLD and HCC mortality and by more than 80 percent for HCC incidence, which were higher than the previously reported reduction (70 percent) in HCC incidence for youth 6 to 19 years of age.

The mortality of IFH in vaccinated birth cohorts decreased by more than 90 percent from 1977-1980 to 2009-2011, which was greater than the previously reported reduction (approximately 70 percent) from 1975-1984 to 1985-1998. "This long-term, high-coverage immunization program was associated with lower IFH mortality through increasing individual and herd immunity of vaccinated cohorts."

More information: doi:10.l001/jama.2013.276701

add to favorites email to friend print save as pdf

Related Stories

Hepatitis B virus mutations may predict risk of liver cancer

Jul 02, 2009

Certain mutations in the DNA of the hepatitis B virus (HBV) are associated with the development of liver cancer and may help predict which patients with HBV infections are at increased risk of the disease, according to a ...

Recommended for you

Thyroid disease risk varies among blacks, Asians, and whites

8 hours ago

An analysis that included active military personnel finds that the rate of the thyroid disorder Graves disease is more common among blacks and Asian/Pacific Islanders compared with whites, according to a study in the April ...

The key to easy asthma diagnosis is in the blood

11 hours ago

Using just a single drop of blood, a team of University of Wisconsin-Madison researchers has developed a faster, cheaper and more accurate tool for diagnosing even mild cases of asthma.

Younger adults hit hardest this flu season

13 hours ago

(HealthDay)—The H1N1 flu was the predominant influenza strain in the United States this year, but it packed a lot less punch than in 2009 when it caused a worldwide pandemic, health officials report.

User comments