TY - JOUR
T1 - Slow decline of hepatitis B burden in general population
T2 - Results from a population-based survey and longitudinal follow-up study in Taiwan
AU - Chen, Chi Ling
AU - Yang, Jyh Yuan
AU - Lin, Szu Fong
AU - Sun, Chien An
AU - Bai, Chyi Huey
AU - You, San Lin
AU - Chen, Chien Jen
AU - Kao, Jia Horng
AU - Chen, Pei Jer
AU - Chen, Ding Shinn
N1 - Publisher Copyright:
© 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Background & Aims: Hepatitis B virus (HBV) infection poses a global public health threat. HBV vaccination has proven highly effective in preventing the infection; however, its long-term impact on the general population has not been addressed. We conducted analysis to determine the total and changing burden of chronic HBV infection and evaluate the serological status between vaccinated and unvaccinated in Taiwan. Methods: Participants in "The Taiwanese Survey on Prevalence of Hyperglycemia, Hyperlipidemia and Hypertension" in 2002 (n = 6602), and 4088 with follow-up survey in 2007 were included. HBsAg (including titers), anti-HBs, anti-HBc, HBeAg, anti-HBe, HBV genotypes and viral loads were assayed. Prevalence and evolving patterns of these seromarkers was compared between vaccinated and unvaccinated cohorts and predictors of persistent HBsAg positivity and negativity were examined. Results: The overall prevalence of chronic HBV infection was 13·7% (95% CI, 12.9% to 14.5%) and about two thirds had past exposure (anti-HBc: 68·46%) in 2002. The vaccinated cohort tended to have lower prevalence of HBsAg and anti-HBc, and a higher proportion of anti-HBs and HBeAg positivity, genotype C and high viral load. The majority (85·42%) were consistently HBsAg negative while 12·65% were consistently positive, and 8·98% achieved seroclearance in a five-year period. In the vaccinated cohort, no subjects had acquired new exposure and became HBsAg positive, and only one (0.54%) cleared HBsAg, demonstrating the durability of vaccination through teenage and young adulthood. Conclusions: This comprehensive, population-representative-sur vey shows that 20 years after universal vaccination, the backlog still composed a substantial burden of chronic HBV infections in Taiwan.
AB - Background & Aims: Hepatitis B virus (HBV) infection poses a global public health threat. HBV vaccination has proven highly effective in preventing the infection; however, its long-term impact on the general population has not been addressed. We conducted analysis to determine the total and changing burden of chronic HBV infection and evaluate the serological status between vaccinated and unvaccinated in Taiwan. Methods: Participants in "The Taiwanese Survey on Prevalence of Hyperglycemia, Hyperlipidemia and Hypertension" in 2002 (n = 6602), and 4088 with follow-up survey in 2007 were included. HBsAg (including titers), anti-HBs, anti-HBc, HBeAg, anti-HBe, HBV genotypes and viral loads were assayed. Prevalence and evolving patterns of these seromarkers was compared between vaccinated and unvaccinated cohorts and predictors of persistent HBsAg positivity and negativity were examined. Results: The overall prevalence of chronic HBV infection was 13·7% (95% CI, 12.9% to 14.5%) and about two thirds had past exposure (anti-HBc: 68·46%) in 2002. The vaccinated cohort tended to have lower prevalence of HBsAg and anti-HBc, and a higher proportion of anti-HBs and HBeAg positivity, genotype C and high viral load. The majority (85·42%) were consistently HBsAg negative while 12·65% were consistently positive, and 8·98% achieved seroclearance in a five-year period. In the vaccinated cohort, no subjects had acquired new exposure and became HBsAg positive, and only one (0.54%) cleared HBsAg, demonstrating the durability of vaccination through teenage and young adulthood. Conclusions: This comprehensive, population-representative-sur vey shows that 20 years after universal vaccination, the backlog still composed a substantial burden of chronic HBV infections in Taiwan.
KW - HBV vaccination
KW - Hepatitis B virus infection prevalence
KW - Longitudinal follow-up survey
KW - Population-based survey
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U2 - 10.1016/j.jhep.2015.03.013
DO - 10.1016/j.jhep.2015.03.013
M3 - Article
C2 - 25795588
AN - SCOPUS:84942828021
SN - 0168-8278
VL - 63
SP - 354
EP - 363
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 2
ER -