Elimination of hepatitis B virus infection in children: experience and challenge in China

Abstract

Chronic hepatitis B virus (HBV) infection is a serious health issue because of its severe sequelae. Prevention of mother-to-child transmission (MTCT) of HBV is critical to eliminate chronic HBV infection. Here, we reviewed the progress toward the elimination of HBV infection in children in China in the recent decade. A universal hepatitis B vaccination program started from 2002 has been intensified, with the coverage of timely birth dose >95% of all newborn infants from 2012. Since 2011, China has taken a nationwide program to administer hepatitis B immunoglobulin (HBIG) with free of charge in all neonates of HBV-infected mothers, leading to a significant increment of timely use of HBIG. The prevalence of hepatitis B surface antigen (HBsAg) was declined from around 10% among children in 1980s to <0.5% among children born after 2011. Administration of oral antiviral agents in HBV-infected pregnant women with HBV DNA >2 × 10 5 U/mL during the third trimester is increasing, which will further reduce MTCT of HBV. However, there are some challenges in the elimination of HBV infection in children, which need to overcome by the concerted efforts. Nevertheless, it is anticipated that China will achieve the goal set by the World Health Organization that the prevalence of HBsAg in children aged <5 years is ≤0.1% by 2030.

Efficacy of the hepatitis B vaccine alone in the prevention of hepatitis B perinatal transmission in infants born to hepatitis B e antigen-negative carrier mothers

“…1 , 6 In China, the coverage of a timely birth dose since 2012 has reached >95%, and the HBV prevalence in 2014 in children younger than 4 years old had declined to 0.3%, as compared to 10% before the availability of HBIG and HBV imminization. 25 , 26 …”

Inspiration to mRNA-based COVID-19 vaccination: Serious adverse case reports with hepatitis B vaccine in real-world

“…More than 800,000 people die from the Hepatitis B virus each year, and vaccination is the most cost-effective way to prevent the spread of the virus (1,2). About 10% of the Chinese population carries the hepatitis B virus, and the Chinese government has implemented universal free hepatitis B vaccination since 2002 (3). Five enterprises in China produce hepatitis B vaccines, all recombinant hepatitis B vaccines.…”

For the health of the people—commemorating the 135th anniversary of the founding of the Chinese Medical Journal

“…[ 49 ] Yihua Zhou described the progress of eradicating chronic hepatitis B in children by preventing mother-child transmission of this disease. [ 50 ]…”

“…[49] Yihua Zhou described the progress of eradicating chronic hepatitis B in children by preventing mother-child transmission of this disease. [50] Since the beginning of the 21 st century, emerging infectious diseases have become a major risk, endangering public health. After the outbreak of severe acute respiratory syndrome in 2003, our medical community made a swift response.…”

“…With regard to the prevention and control of chronic infectious diseases, Hong Shang introduced the experience gained by China in the prevention and control of acquired immune deficiency syndrome over the past 30 years [49] . Yihua Zhou described the progress of eradicating chronic hepatitis B in children by preventing mother-child transmission of this disease [50] …”