Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 28, 2015; 7(18): 2127-2132
Published online Aug 28, 2015. doi: 10.4254/wjh.v7.i18.2127
Three decades of hepatitis B control with vaccination
Liliane C Meireles, Rui Tato Marinho, Pierre Van Damme
Liliane C Meireles, Rui Tato Marinho, Department of Gastroenterology and Hepatology, Centro Hospitalar Lisboa Norte, 1649-035 Lisbon, Portugal
Pierre Van Damme, Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, 2610 Antwerp, Belgium
Author contributions: Meireles LC contributed to preparation and critical review of the manuscript; Marinho RT and Van Damme P contributed to critical review of the manuscript.
Conflict-of-interest statement: Liliane C Meireles and Rui Tato Marinho declare to no conflict-of-interest. Pierre Van Damme acts as chief and principal investigator for vaccine trials conducted on behalf of the University of Antwerp, for which the University obtains research grants from vaccine manufacturers; speakers fees for presentations on vaccines and other research grants are paid directly to an educational fund held by the University of Antwerp. Van Damme P receives no personal remuneration for this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Liliane C Meireles, MD, Department of Gastroenterology and Hepatology, Centro Hospitalar Lisboa Norte, Avenida Egas Moniz, 1649-035 Lisbon, Portugal. lilianeenailil@gmail.com
Telephone: +351-91-6747892 Fax: +351-21-7805610
Received: May 9, 2015
Peer-review started: May 9, 2015
First decision: July 6, 2015
Revised: July 23, 2015
Accepted: July 29, 2015
Article in press: August 3, 2015
Published online: August 28, 2015

Hepatitis B virus (HBV) continues to represent a major health problem and can lead to acute liver failure, acute hepatitis, chronic carriership, chronic hepatitis of HBV, liver cirrhosis, liver cancer, liver transplantation and death. There is a marked difference in the geographic distribution of carriers. More than 240 million people worldwide are chronic HBV carriers. Mother-to-child transmission remains the most important mechanism of infection in countries with a high prevalence of HBV. Percutaneous/parenteral transmission and unsafe sexual practices are important mode of spread transmission of HBV in other countries. Vaccination against HBV is the gold measure for primary prevention and control of the disease. Currently, 179 countries have added HBV vaccination to their routine vaccination programs with great results. Neonatal immunization with HBV vaccine has been one of the most highly effective measures in public health and the first anti-cancer program to be launched. In this paper we review the achievements for the last three decades.

Keywords: Cirrhosis, Vaccination, Primary prevention, Hepatocellular carcinoma, Hepatitis B

Core tip: It is now 50 years since the discovery of the hepatitis B virus (HBV). Effective vaccines have been available since the 80s and vaccination has proved to confer lifelong protection against hepatitis B and was highly successful in reducing the disease burden. However, the occurrence of breakthrough infections, the immunological effect of natural boosting and the effectiveness of universal hepatitis B vaccination remains a challenge. The fight against HBV is not over yet, but the broad use of vaccination is the cornerstone and the most important measure to control HBV and all its consequences.