Protecting Future Generations through Immunization against Hepatitis B

• Immunization
• Hepatitis B vaccines
• Hepatitis B, chronic
• Carcinoma, hepatocellular
• Immunization programs

Immunization with hepatitis B vaccine is our most effective weapon against hepatitis B virus (HBV) infection and its consequences. Among the estimated 1.25 million persons with chronic HBV infection in the United States, chronic liver disease and primary hepatocellular carcinoma cause an estimated 5000 deaths per year. Because the risk for chronic infection increases with decreasing age, persons infected in early childhood carry a disproportionately large burden of morbidity and mortality attributable to HBV. Adults who have had chronic HBV infection since childhood develop primary hepatocellular carcinoma at a rate of 5% per decade, which is 100 to 300 times the rate among uninfected persons.

The major objective of hepatitis B immunization is to prevent chronic infection, which will prevent sequelae such as primary hepatocellular carcinoma. In developing countries, where most infections are acquired in infancy and early childhood, routine childhood immunization against hepatitis B has been the primary strategy to accomplish this objective. The results of the study by Ni and colleagues (1) in this issue clearly show the success of this strategy in interrupting HBV transmission and preventing chronic infection. During the 15 years after routine childhood hepatitis B immunization was implemented in Taiwan, the prevalence of chronic HBV infection among children younger than 15 years of age declined …