Hepatitis B vaccination: The key towards elimination and eradication of hepatitis B

Abstract

Hepatitis B virus infection is a global health problem. Worldwide, about 360 million people are chronically infected with the virus. They continue to spread the virus to others and are themselves at risk of chronic liver diseases and hepatocellular carcinoma. The infection can now be treated by antivirals or interferons and the transmission route can be interrupted. Nevertheless, the most effective means is to immunize all susceptible individuals, especially young children, with safe and efficacious vaccines. The combined efforts of vaccination, effective treatment and interruption of transmission make elimination of the infection plausible and may eventually lead to eradication of the virus. Because hepatitis B vaccination has a key role in the control of hepatitis B, properties of this vaccine, its effectiveness in pre-exposure and post-exposure settings, duration of protection after vaccination and the need of booster doses are discussed. Mass hepatitis B vaccination in children decreases the carriage of the virus, and the diseases associated with acute and chronic infection, including hepatocellular carcinoma. Challenges that need to be solved to expand mass vaccination, and the strategies towards elimination and eventual eradication of hepatitis B in the world are also discussed.

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

“…102 According to the World Health Organization, an anti-HBs concentration of ‡10 mIU ⁄ mL measured 1-3 months after administration of the last dose of the primary vaccination series is considered a reliable marker of protection against infection. 9,77,80,81,97,[102][103][104] As time passes, anti-HBs titres frequently become undetectable. A number of long-term studies performed in different epidemiological contexts have confirmed that clinical HBV infection rarely occurs among successfully vaccinated individuals even though the anti-HBs concentrations decline to <10 mIU ⁄ mL over time.…”

“…81 Thus, the vaccine-induced immunologic memory is maintained for at least 12 years in non-immunocompromised persons despite the decline in anti-HBs titres. 104 Limited data are available on the duration of immune memory after hepatitis B vaccination in immunocompromised patients. In studies of long-term protection among HIV-infected persons, breakthrough infections occurring after a decline in anti-HBs concentrations to <10 mIU ⁄ mL have been transient and asymptomatic.…”

Fighting against viral hepatitis: Lessons from Taiwan

“…Similar results were also found in other places of Taiwan. 51 In 2005, a study on 1,545 randomly sampled first graders of elementary schools found 12 HBsAg carriers (0.78%) only. 52 Although HBsAg carriage has decreased, the most important issue is whether the diseases caused by HBV have decreased.…”

“…I strongly believe that vaccination is the key to the elimination and eradication of HBV. 51,61 The success of the VHCP can be attributed to the Taiwanese government's determination, a welldesigned program, effective implementation, and appropriate assessment (Table 1). Other factors have also contributed to the success, including the fact that Taiwan is a small island country with a good public health delivery system and household registration, that its people are well-educated and understand the importance of vaccination, and so forth.…”

Functional Characterization of Interferon Regulation Element of Hepatitis B virus Genome In Vivo

“…Although a highly effective preventive vaccine is available [5], it does not help the estimated 350 million people who have already been infected chronically and are at higher risk of developing hepatic cirrhosis and hepatocellular carcinoma, the predominant causes of mortality due to HBV infection [3]. In recent years, several antiviral drugs have been developed for the treatment of chronic hepatitis B patients.…”