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

World J Gastroenterol. 2014 Jul 21;20(27):8998-9016. doi: 10.3748/wjg.v20.i27.8998.

Abstract

Hepatitis B (HB) virus (HBV) infection, which causes liver cirrhosis and hepatocellular carcinoma, is endemic worldwide. Hepatitis B vaccines became commercially available in the 1980s. The World Health Organization recommended the integration of the HB vaccine into the national immunisation programs in all countries. HBV prevention strategies are classified into three groups: (1) universal vaccination alone; (2) universal vaccination with screening of pregnant women plus HB immune globulin (HBIG) at birth; and (3) selective vaccination with screening of pregnant women plus HBIG at birth. Most low-income countries have adopted universal vaccine programs without screening of pregnant women. However, HB vaccines are not widely used in low-income countries. The Global Alliance for Vaccine and Immunization was launched in 2000, and by 2012, the global coverage of a three-dose HB vaccine had increased to 79%. The next challenges are to further increase the coverage rate, close the gap between recommendations and routine practices, approach high-risk individuals, screen and treat chronically infected individuals, and prevent breakthrough infections. To eradicate HBV infections, strenuous efforts are required to overcome socioeconomic barriers to the HB vaccine; this task is expected to take several decades to complete.

Keywords: Cancer; Global Alliance for Vaccine and Immunization; Hepatitis B immune globulin; Hepatitis B virus; Hepatocellular carcinoma; Selective vaccination; Universal vaccination; World Health Organization.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Developing Countries* / economics
  • Disease Eradication* / economics
  • Disease Eradication* / standards
  • Drug Costs
  • Female
  • Global Health
  • Health Services Accessibility
  • Hepatitis B / diagnosis
  • Hepatitis B / economics
  • Hepatitis B / epidemiology
  • Hepatitis B / prevention & control*
  • Hepatitis B / transmission
  • Hepatitis B Vaccines / adverse effects
  • Hepatitis B Vaccines / economics
  • Hepatitis B Vaccines / supply & distribution
  • Hepatitis B Vaccines / therapeutic use*
  • Hepatitis B virus / drug effects*
  • Hepatitis B virus / pathogenicity
  • Humans
  • Immunization Programs* / economics
  • Immunization Programs* / standards
  • Infant
  • Infant, Newborn
  • Male
  • Practice Guidelines as Topic
  • Pregnancy
  • Treatment Outcome
  • Young Adult

Substances

  • Hepatitis B Vaccines