A Mass Vaccination Program in Taiwan Against Hepatitis B Virus Infection in Infants of Hepatitis B Surface Antigen—Carrier Mothers

Chen, Ding‐Shinn; Hsu, Nora Hsu‐Mei; Sung, Juei‐Low; Hsu, Tzu-Chiu.; Hsu, S.T.D.; Kuo, You-Tseng; Lo, Kwang‐Juei; Shih, Yaw-Tang

doi:10.1001/jama.1987.03390190075023

Cited by 292 publications

(185 citation statements)

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“…The first HBV mass vaccination program in the world was launched in Taiwan on July 1, 1984 [Chen et al, 1987]. The first 2 years of the program covered all infants of HBsAg carrier mothers.…”

Section: Discussionmentioning

confidence: 99%

“…The carrier rate of hepatitis B surface antigen (HBsAg) in the general population was about 15%-20%, one of the highest in the world [Chen, 1996]. The first HBV mass vaccination program in the world was launched in Taiwan on July 1, 1984 [Chen et al, 1987]. The HBsAg carrier rate is up to 100 times higher in developing countries than in developed countries [Chiaramonte et al, 1991].…”

Section: Introductionmentioning

confidence: 99%

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Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan

Lin

Chen

et al. 2005

Journal of Medical Virology

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Taiwan was a hyperendemic area for hepatitis A and B viruses (HAV and HBV) infection before late 1980s. To study the seroprevalence of hepatitis A, B, C, and E viruses (HCV and HEV) infection among preschool children in Taiwan, a community‐based survey was carried out in 54 kindergartens in 10 urban areas, 10 rural areas, and 2 aboriginal areas randomly selected through stratified sampling. Serum specimens of 2,538 preschool children were screened for the hepatitis A, C, and E antibodies by a commercially available enzyme immunoassay and for HBV markers by radioimmunoassay methods. The multivariate‐adjusted odd ratios (OR) with their 95% confidence intervals (CI) were estimated through the multiple logistic regression analysis. Females had a statistically significantly higher HAV seroprevalence than males. The seroprevalence of HCV infection increased significantly with age. The larger the sibship size, the higher the seroprevalence of HBV infection. Aboriginal children had a significantly higher seroprevalence of HBV and HEV infection and lower seroprevalence of HCV infection than non‐aboriginal children. A significantly higher seroprevalence of HBV infection was found in rural children than urban children. There was no significant association between serostatus of HAV and HEV infection and between serostatus of HBV and HCV infection among preschool children in Taiwan. The poor environmental and hygienic conditions in the aboriginal areas might play a role in infection with HBV and HEV. J. Med. Virol. 78:18–23, 2006. © 2005 Wiley‐Liss, inc.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan

Lin

Chen

et al. 2005

Journal of Medical Virology

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“…8 To combat HBV infection in Taiwan, a mass immunization program has been launched on July 1, 1984, aiming first at the prevention of perinatal mother-to-infant, chronic HBV infection. 9 This nationwide vaccination program has markedly decreased the HBV carrier rate 10 and childhood HBVrelated HCCs (B-HCCs). 11 An 80-85% decrease in HCC among Taiwanese adults up to 3-4 decades later is anticipated.…”

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confidence: 99%

Secular trends and geographic variations of hepatitis B virus and hepatitis C virus‐associated hepatocellular carcinoma in Taiwan

Yang

et al. 2006

Intl Journal of Cancer

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128

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Etiological variations in hepatocellular carcinoma (HCC) exist across different geographic areas. To gain better control of HCC, we retrospectively studied the secular trends and geographic variations in hepatitis B virus (HBV)-related and hepatitis C virus (HCV)-related HCCs in Taiwan. A total of 18,423 HCC cases enrolled in 8 medical centers from 1981 to 2001 were reviewed. Overall, 67% of male HCC in Taiwan was related to HBV infection whereas 55.2% of female HCC in Taiwan was related to HCV infection. The mean age of patients with HBV-related HCC was 53.2 6 13.6 years, while the mean age of patients with HCV-related HCC was 65.1 6 9.1 years (p < 0.001). The male/female ratio was 6.4 for HBV-related HCC, while it was 1.7 for the HCV-related HCC (p < 0.001). The percentage of HBV-related HCC progressively decreased from 81.5 to 66.2% in males, and from 66.7 to 41.4% in females over the study period. Our study demonstrates that the percentage of HBV-related HCC has progressively decreased over the last 20 years. The relative decrease in HBV-related HCC was not due to a decrease in HBV-related HCC death. Instead, it was caused by an increase in HCV-related HCC. Prevention of new HCV infection and the treatment of chronic hepatitis C should be the primary goals, which will result in better control of HCC in the future, even in an HBV-endemic area like Taiwan. ' 2006 Wiley-Liss, Inc.Key words: hepatocellular carcinoma; hepatitis B virus; hepatitis C virus; secular trend; geographic variation; Taiwan Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, especially in sub-Saharan Africa and Southeast Asia. Since 1984, it has been the leading cause of cancer death in Taiwan, 1 accounting for approximately 7,000 death annually. In addition, around 8,000 new HCC cases are diagnosed each year. 2 High-risk groups for HCC include patients chronically infected with hepatitis B virus (HBV) or hepatitis C virus (HCV), liver cirrhosis patients, and people with a family history of HCC. Chronic HBV and HCV infections are the 2 major etiologies of HCC in Taiwan. 3 About 15-20% of the general population in Taiwan are chronic carriers of hepatitis B surface antigen (HBsAg). 4 HBV carriers have a 20-to 98-fold increased risk of HCC, 5,6 especially among the hepatitis B e antigen (HBeAg)-positive group. 7 A recent prospective study has further confirmed that positivity for HBeAg is associated with an increased risk of HCC. 8 To combat HBV infection in Taiwan, a mass immunization program has been launched on July 1, 1984, aiming first at the prevention of perinatal mother-to-infant, chronic HBV infection. 9 This nationwide vaccination program has markedly decreased the HBV carrier rate 10 and childhood HBVrelated HCCs (B-HCCs). 11 An 80-85% decrease in HCC among Taiwanese adults up to 3-4 decades later is anticipated. 12 The prevalence of anti-HCV antibody (anti-HCV) is 2-4% among the general population of Taiwan, 13 while it ranges from 0.95 to 2.2% in Taiwanese blood donors. 13,14 The anti-HCV prevalen...

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“…44 The top priority was to immunize newborns. Because of the complexity of this program, in 1984 and 1985, we targeted at the newborns of hepatitis B carrier mothers.…”

Section: The Universal Hepatitis B Mass Vaccination Program In Infantsmentioning

confidence: 99%

“…From 1986, it was extended to all newborns. 44 The efficacy of the program was seen 18 months later: 85% of the infants born to HBsAg carrier mothers were protected from chronic HBV infection. 45 Hsu-Mei Hsu of the Department of Health did a superb job, and the program was very well implemented.…”

Section: The Universal Hepatitis B Mass Vaccination Program In Infantsmentioning

confidence: 99%

Fighting against viral hepatitis: Lessons from Taiwan

Chen

2011

Hepatology

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Viral hepatitis and its sequelae are important health problems worldwide, including Taiwan. For the last 40 years, Taiwan's scientists and health care providers have worked hard to control these sequelae, and the results have been excellent. The author, Ding-Shinn Chen, had a key role in planning and establishing the control program in Taiwan, and participated in the endeavors from the very beginning. In this perspective, he describes how he became interested in research as a medical student, his encounters with hepatitis B and C, how he and his colleagues started early detection of hepatocellular carcinoma (HCC), how he helped Taiwan's government create and implement the Viral Hepatitis Control Program, and how the effectiveness of the program in the decrease of hepatitis B carriage and HCC was monitored. He also discusses how he pioneered the use of interferon-α plus ribavirin to treat chronic hepatitis C. Hepatitis B viral load as a risk factor for HCC and cirrhosis in hepatitis B surface antigen carriers is reviewed briefly, as is the prevention of sequelae by antiviral therapies. Finally, Dr. Chen discusses unresolved issues that must be addressed and predicts the changes of the patterns of liver disease in Taiwan beyond the mid-21st century, which is in part affected by the fight against viral hepatitis that was initiated in the early 1980s. Conclusion : Dr. Chen's perspective illustrates Taiwan's fight against viral hepatitis over the last 40 years. This experience can be shared by other countries in which the disease is equally prevalent. (Hepatology 2011;)

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A Mass Vaccination Program in Taiwan Against Hepatitis B Virus Infection in Infants of Hepatitis B Surface Antigen—Carrier Mothers

Cited by 292 publications

References 9 publications

Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan

Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan

Secular trends and geographic variations of hepatitis B virus and hepatitis C virus‐associated hepatocellular carcinoma in Taiwan

Fighting against viral hepatitis: Lessons from Taiwan

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