The effectiveness of the infant hepatitis B immunisation program in Fiji, Kiribati, Tonga and Vanuatu

An overview of hepatitis B prevalence, prevention, and management in the Pacific Islands and Territories

“…In Fiji, HBsAg prevalence was 6.9% in students and 6.6% in pregnant women; in Kiribati, HBsAg prevalence was 27.4% among students and 15.1% among pregnant women; in Tonga, HBsAg prevalence was 11.1% among students and 18.6% among pregnant women; and in Vanuatu HBsAg prevalence was 16.3% among students and 12.3% among mothers. 32 Generally, HBsAg prevalence was higher among unvaccinated young students compared with pregnant women, likely reflecting spontaneous HBsAg clearance with time.…”

“…HBeAg positivity was high in pregnant women, being 52% overall and ranging from 48% in the Kiribati and Tongan cohorts to 70% in the Fijian cohort. 32 Two further studies from the Solomon Islands reported HBeAg prevalence of 41.3% in the general HBsAg-positive community, 38 and 47% among HBsAg pregnant women. 40 No studies provided data on HBV DNA levels.…”

“…4 There is very little published data on the epidemiology of HBV transmission in PICT. Data from the study by Wilson et al 32 showed that 52% of 814 pregnant women across the four major islands were HBeAg positive, and are therefore at high risk for vertical transmission. Of the 784 vaccinated children born to HBsAg-positive mothers, 20 (2.9%) were HBsAg positive, reinforcing that vertical HBV transmission can occur despite HBV vaccination commencing at birth.…”

“…A study from Vogt et al 36 evaluated the cause of 1608 deaths between 1990 and 2002 in Palau and found chronic liver disease was the fifth Figure 3 Schematic map of HBV surface antigen (HBsAg) prevalence by nation in the Western Pacific Islands. Data taken from cross-sectional cohort studies published from 1994 to present, which may not accurately represent current HBsAg prevalence in the general population [32][33][34][35][36][37][38][39][40][41] . , No, data; , 0-5%; , 6-10%; , 11-15%; , > 15%.…”

Evidence-based clinical guidelines for immigrants and refugees

“…180 The relative risk of chronic infection with hepatitis B virus among vaccinated preschoolers relative to historical school-aged controls ranged from 0.1 to 0.34 in four South Pacific islands. 181 Finally, after 15 years of follow-up, a universal infant and childhood vaccination program in Taiwan showed a dramatic decrease in seropositivity for hepatitis B surface antigen (from 9.8% to 0.7%) and a 49% decrease in incidence of hepatocellular carcinoma, to just over half the initial rate (from 0.7 to 0.36 per 100 000 population) (Table 6C). …”