Elimination of hepatocellular carcinoma and acute hepatitis B in children 25 years after a hepatitis B newborn and catch-up immunization program

June 6, 2011

Hepatology. 2011 May 26. doi: 10.1002/hep.24442. [Epub ahead of print]

Elimination of hepatocellular carcinoma and acute hepatitis B in children 25

years after a hepatitis B newborn and catch-up immunization program.

McMahon BJ, Bulkow LR, Singleton RJ, J, Snowball M, Homan C, Parkinson

AJ.

Source

Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium,

Anchorage Alaska; Arctic Investigations Program, Division of Preparedness and

Emerging Infections, National Center for Emerging and Zoonotic Infectious

Diseases, Centers for Disease Control and Prevention, Anchorage Alaska.

bdm9@....

Abstract

Alaska Native people experienced the highest rates of acute and chronic

hepatitis B virus (HBV) infection, and hepatocellular carcinoma (HCC) in the

United States. We examine the effect of a universal newborn immunization with

hepatitis B vaccine and mass population screening immunization program initiated

in 1984 on rates of HBV and HCC in children 25 years later. During this time

period, the population of Alaska Native people grew from an estimated 75,000 to

130,000 persons. A surveillance system to detect acute HBV infection in Alaska

Native facilities was established in 1981. Cases of HCC in children under 20

years of age were identified using a National Cancer Institute (NCI) funded

Cancer Registry established in 1969 coupled with an active surveillance program

of screening persons with chronic HBV semiannually for alpha-fetoprotein since

1982. The incidence of acute symptomatic HBV infection in persons < 20 years of

age fell from cases 19/100,000 in 1981-1982 to 0/100,000 in 1993-94,

respectively. No cases of acute HBV have occurred in children since 1992. The

incidence of HCC in persons < 20 years decreased from 3/100,000 in 1984-1988 to

zero in 1995-1999 and no cases have occurred since 1999. The number of

identified HBsAg-positive children < 20 years in the Alaska Native Population

declined from 657 in 1987 to two in 2008. Universal newborn vaccination coupled

with mass screening and immunization of susceptible Alaska Native has eliminated

HCC and acute symptomatic HBV infection among Alaska Native children and this

approach is the best way to prevent HBV related disease in children.

(HEPATOLOGY 2011.).

PMID: 21618565 [PubMed - as supplied by publisher]

June 6, 2011