[Hepatocellular carcinoma: a preventable cancer]

Area of Science:

• Public Health
• Vaccinology
• Hepatology

Background:

• Hepatocellular carcinoma (HCC) is a major global cancer, particularly in developing nations.
• Chronic hepatitis B virus (HBV) carriage, prevalent in Africa and Asia, is a primary risk factor for HCC.
• Hepatitis C virus (HCV) infection, aflatoxin exposure, and alcohol consumption are also significant risk factors.

Purpose of the Study:

• To evaluate the efficacy of early infant hepatitis B vaccination in preventing HBV infection and chronic carriage.
• To assess the long-term impact of vaccination on reducing hepatocellular carcinoma (HCC) incidence.

Main Methods:

• A randomized vaccine trial involving 124,577 children over four years in The Gambia.
• Participants received either standard EPI vaccines or EPI vaccines plus hepatitis B vaccine.
• Established a nationwide Cancer Registry to monitor HCC cases within the study cohort.

Main Results:

• Hepatitis B vaccine demonstrated 84% efficacy against HBV infection in four-year-old children.
• Vaccine efficacy reached 94% in preventing chronic HBV carriage status.
• Hepatitis B vaccination has been integrated into The Gambia's national immunization program.

Conclusions:

• Early infant hepatitis B vaccination is highly effective in preventing HBV infection and chronic carriage.
• The vaccination strategy holds significant promise for long-term HCC prevention in The Gambia.
• Ongoing follow-up via the Cancer Registry will provide further insights into HCC reduction.