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Seroepidemiologic survey for hepatitis B virus infection in Taiwan: the effect of hepatitis B mass immunization
1Bureau of Communicable Disease Control, Department of Health, Executive Yuan, Taipei, Taiwan. cdhsu_hm@dohr6.doh.gov.tw
Insights
Taiwan's hepatitis B mass immunization program significantly reduced chronic hepatitis B infection. Universal newborn immunization proved more effective than selective programs, demonstrating the strategy's success in controlling the disease.
Area of Science:
- Public Health
- Immunology
- Epidemiology
Background:
- Hepatitis B virus (HBV) infection is a major global health concern.
- Taiwan initiated a hepatitis B mass immunization program in July 1984.
Purpose of the Study:
- To evaluate the long-term effectiveness of Taiwan's hepatitis B mass immunization program.
- To compare the impact of selective versus universal HBV immunization strategies.
Main Methods:
- Seroepidemiology was assessed in three cohorts of 6-year-old children.
- Children were sampled from those entering elementary school in 1989, 1991, and 1993.
- Radioimmunoassay (RIA) was used to determine hepatitis B surface antigen, antibody, and infection rates.
Main Results:
- Hepatitis B surface antigen positivity decreased from 10.5% (pre-program) to 1.7% (3 years into universal program).
- Hepatitis B infection rates dropped significantly from 25.0% to 4.3% over the study period.
- Universal immunization demonstrated superior efficacy in reducing HBV carriage compared to selective immunization.
Conclusions:
- Taiwan's universal hepatitis B immunization program has been highly effective in controlling chronic HBV infection.
- The findings support the widespread implementation of universal hepatitis B vaccination for disease prevention.
Abstract:
A hepatitis B mass immunization program was launched in Taiwan in July 1984, beginning with newborns of hepatitis B carrier mothers for the first 2 years of the program, which was then extended to all newborns. Seroepidemiology was studied in 3 cohorts at age 6 years. Each cohort consisted of 1500 children proportionally and randomly sampled from those entering elementary school in 1989, 1991, and 1993, representing those born 1 year before the program began and years 1 and 3 of the program, respectively. By RIA, the hepatitis B surface antigen positivity rates in the groups were 10.5%, 6.3%, and 1.7%, respectively; hepatitis B surface antibody positivity rates were 36.9%, 62.0%, 65.4%; and hepatitis B infection rates were 25.0%, 15.9%, 4.3%. Thus, universal immunization was more effective in reducing hepatitis B carriage than selective immunization of newborns of carrier mothers only. The program has proved effective in controlling chronic hepatitis B infection in Taiwan.