Hepatitis B virus: Where do we stand and what is the next step for eradication?

Table 1 Classification of hepatitis B vaccine prevention strategies

	Universal vaccination alone	Universal vac. + pregnant-women screening + HBIG	Selective vaccination + pregnant-women screening + HBIG
Low- and intermediate-income countries1	√
High-and intermediate-income countries1		√
(e.g., European countries, United States)
High-income countries (e.g., Scandinavian countries, United Kingdom, Japan)			√

¹Intermediate-income countries are using a variety of vaccination strategies; HBIG: Hepatitis B immune globulin.

Table 2 Hepatitis B surface antigen prevalence before and after the introduction of universal vaccination for hepatitis B virus

Ref.	Region	Country		Subjects	Year of the introduction of infant universal vaccination	HBsAg positive rate
						Before-vaccination program	Year	After vaccination program	Year
95	North America	United States	(Hawai)	School children	1992	1.6%	1989	0.04%	2001-2002
96	South America	Colombia	(Colombian Amazon)	5-9 yr of age	1992	7%	1992	2%	1999
97	Asia	Taiwan	(Taipei)	≤ 12 yr of age	1984	9.8%	1984	1.3%	1994
94	Asia	China		Young children	1992	9%-12%	1992	< 1%	2005
98	Europe	Italy	(Afragola)	General population	1991	13.4%	1978	0.91%	2006
99	Africa	South Africa	(Gauteng Province)	≤ 24 mo after birth	1995	8%-9%	1995-1996	0.9%	2003-2004
100	Africa	Gambia	(Keneba)	≤ 24 yr of age	1984	13.3%	1984	0.6%	2003
100	Africa	Gambia	(Mandar)	≤ 24 yr of age	1984	35%	1984	1%	2003

Table 3 Incidence of acute hepatitis B before and after the introduction of universal vaccination for hepatitis B virus

Ref.	Region	Country	Subjects	Year of the introduction of universal vaccination	Annual incidence of acute hepatitis B cases per 100000 population
					Before vaccination program	Year	After vaccination program	Year
101	North America	United States	0-19 yr of age	1992	3	1990	0.3	2002
102		United States (Alaska)	Under 20 yr of age	1984	19	1981-1920	0	1993-1994
103	Asia	Taiwan	Infants	1984	5.36	1975-1984	1.71	1993-1994
104	Europe	Italy	General population	1991	5.1	1991	1.3	2005

Table 4 Incidence of hepatocellular carcinoma before and after the introduction of universal vaccination for hepatitis B virus

Ref.	Country	Subjects	Year of the introduction of universal vaccination	Annual incidence of HCC cases per 100000 population
				Before vaccination program	Year	After vaccination program	Year
102	United States (Alaska)	Under 20 yr of age	1984	3	1984-1988	0	1995-1999
109	Taiwan	6-14 yr of age	1984	0.7	1981-1986	0.36	1990-1994
109	Taiwan	6-9 yr of age	1984	0.52	1974-1984	0.13	1984-1986

HCC: Hepatocellular carcinoma.