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Can We Really Wipe Out Hepatitis B?

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WebMD Health News
Reviewed by Gary D. Vogin, MD

Nov. 5, 2001 -- New studies confirm that thousands of lives will be saved in the United States and around the world thanks to the vaccination of infants against hepatitis B virus. But many still will die needlessly from hepatitis B-related liver disease in the decades to come, experts say, because not enough teens and high-risk adults are being vaccinated.

 

National figures suggest that 90% of children in the U.S. are receiving the three doses of hepatitis B vaccine required to confer immunity by their second birthday. As a result, there has been a 75% reduction in hepatitis B virus (HBV) infections among children younger than 15 in the decade since infant vaccinations were initiated, the CDC estimates.

 

A growing number of states are requiring proof of hepatitis B vaccination for entry into middle school, but CDC figures also show that just 48% of 13- to 15-year-olds have been immunized. Adolescents are falling through the cracks, health officials warn, and the consequences will be deadly. That is because a large percentage of HBV transmissions occur among teens and young adults.

 

"One in 20 (unvaccinated) people in the U.S. will get infected with hepatitis B at sometime during their lives," says the CDC's Scott Damon of the division of viral hepatitis. "In 1999, 80,000 people in the U.S. were infected, and roughly 5,000 die each year from illnesses associated with infection. There is no need for that to keep happening because we have a safe and effective vaccine."

 

An estimated 1.25 million people in the United States are chronically infected with HBV, which is transmitted through body fluids and is 100 times more contagious than HIV. Hepatitis B is considered a sexually transmitted infection, but other modes of transmission are common. More than half of the adolescents who become infected are not considered to be at high risk.

 

In the Nov. 5 issue of the journal Pediatrics, CDC researchers report that approximately 16,000 children in the United States under the age of 10 were infected each year with HBV before routine infant immunizations began. That is in addition to approximately 15,000 infections that occur prior to birth each year as infected mothers transmit hepatitis B to their babies.

 

The researchers calculated that as a direct effect of vaccination, 2,700 deaths from chronic liver disease might be prevented each year in the United States.

 

A study from Taiwan, published Nov. 6 in the Annals of Internal Medicine, offers proof that childhood vaccination programs are working in countries where HBV infection is endemic. Before universal immunization 15 years ago, roughly one in five people in the Asian country were infected. The rate of infection plummeted 93% among children younger than 15, from 9.8% in the year the program was initiated to 0.7% in 1999. In addition, the overall prevalence of infection declined dramatically, and the incidence of liver cancer has been cut in half among Taiwanese children.

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