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Global programme for control of hepatitis B infection
1Division of Communicable Diseases, WHO, Geneva, Switzerland.
Insights
Hepatitis B vaccination is crucial for preventing millions of deaths annually from hepatitis B virus (HBV) infection, including liver cancer. Integrating the hepatitis B vaccine into routine infant immunization programs is highly cost-effective and essential for global health.
Area of Science:
- Hepatology
- Public Health
- Vaccinology
Background:
- Hepatitis B virus (HBV) infection affects over 2 billion people globally, with 350 million chronic carriers at high risk of liver disease and cancer.
- HBV infection is a leading cause of morbidity and mortality, causing approximately 1 million deaths each year from acute and chronic sequelae.
- Global health organizations recommend widespread hepatitis B vaccination to control the virus.
Purpose of the Study:
- To assess the global prevalence of HBV infection and chronic carriers.
- To evaluate the impact and cost-effectiveness of hepatitis B vaccine integration into national immunization programs.
- To advocate for universal infant and adolescent hepatitis B immunization strategies.
Main Methods:
- Analysis of global HBV carrier prevalence data.
- Review of national immunization policies and vaccine integration status.
- Assessment of the cost-effectiveness of different HBV vaccination strategies.
Main Results:
- As of 1992, 50 countries included hepatitis B vaccine in routine infant immunization, covering 32% of global newborns and 56% of carriers.
- Countries with high HBV endemicity (≥8% carrier prevalence) were urged to integrate vaccination by 1995, and all countries by 1997.
- Even in low-endemicity areas, universal infant and adolescent vaccination is proving cost-effective, as high-risk group strategies have failed.
Conclusions:
- Universal hepatitis B vaccination is essential to combat the significant global burden of HBV infection.
- Integrating hepatitis B vaccine into routine infant immunization schedules is a highly cost-effective public health intervention.
- Countries should establish working groups to evaluate HBV disease burden and the cost-effectiveness of adding hepatitis B vaccine to immunization programs.
Abstract:
The hepatitis B virus (HBV) has infected more than 2000 million persons alive today and 350 million persons are chronically infected carriers of the virus, at high risk of death from active hepatitis, cirrhosis and primary hepatocellular cancer. Each year approximately 1 million people die from the acute and chronic sequelae of HBV infection, making it one of the major causes of morbidity and mortality in man. In May 1992, the World Health Assembly, the governing body of the World Health Organization, endorsed recommendations stating that countries with an HBV carrier prevalence of 8% or more should have hepatitis B vaccine integrated into their national immunization programmes by 1995 and that all countries should have such immunization in place by 1997. At present, 50 countries have a national policy of including hepatitis B vaccine as a routine part of their infant immunization programme--up from 25 countries in 1990. These countries represent 32% of the world's 145 million newborns, but 56% of the world's carriers. Several countries of 'low' endemicity are also recommending hepatitis B immunization of all newborns or adolescents (or both), realising that the strategy of 'high-risk group' immunization has failed to control HBV infection even in areas of low endemicity and that addition of hepatitis B vaccine to routine immunization schedules is highly cost-effective. All countries should establish working groups to examine the burden of disease due to HBV infection and the cost-effectiveness of adding hepatitis B vaccine to routine and/or adolescent immunization programmes.