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A reduction in chronic hepatitis B virus infection prevalence among children in Vietnam demonstrates the importance of vaccination.

Abstract：

BACKGROUND:Vietnam has high endemic hepatitis B virus infection with >8% of adults estimated to have chronic infection. Hepatitis B vaccine was first introduced in the national childhood immunization program in 1997 in high-risk areas, expanded nationwide in 2002, and included birth dose vaccination in 2003. This survey aimed to assess the impact of Vietnam's vaccination programme by estimating the prevalence of hepatitis B surface antigen (HBsAg) among children born during 2000-2008. METHODS:This nationally representative cross-sectional survey sampled children based on a stratified three-stage cluster design. Demographic and vaccination data were collected along with a whole blood specimen that was collected and interpreted in the field with a point-of-care HBsAg test. RESULTS:A total of 6,949 children were included in the survey analyses. The overall HBsAg prevalence among surveyed children was 2.70% (95% confidence interval (CI): 2.20-3.30). However, HBsAg prevalence was significantly higher among children born in 2000-2003 (3.64%) compared to children born 2007-2008 (1.64%) (prevalence ratio (PR: 2.22, CI 1.55-3.18)). Among all children included in the survey, unadjusted HBsAg prevalence among children with ≥3 doses of hepatitis B vaccine including a birth dose (1.75%) was significantly lower than among children with ≥3 doses of hepatitis B vaccine but lacked a birth dose (2.98%) (PR: 1.71, CI: 1.00-2.91) and significantly lower than among unvaccinated children (3.47%) (PR: 1.99, CI: 1.15-3.45). Infants receiving hepatitis B vaccine >7 days after birth had significantly higher HBsAg prevalence (3.20%) than those vaccinated 0-1 day after birth (1.52%) (PR: 2.09, CI: 1.27-3.46). CONCLUSION:Childhood chronic HBV infection prevalence has been markedly reduced in Vietnam due to vaccination. Further strengthening of timely birth dose vaccination will be important for reducing chronic HBV infection prevalence of under 5 children to <1%, a national and Western Pacific regional hepatitis B control goal.

journal_name

Vaccine

journal_title

Vaccine

authors

Nguyen TH,Vu MH,Nguyen VC,Nguyen LH,Toda K,Nguyen TN,Dao S,Wannemuehler KA,Hennessey KA

doi

10.1016/j.vaccine.2013.11.004

subject

Has Abstract

pub_date

2014-01-03 00:00:00

pages

217-22

issue

2

eissn

0264-410X

issn

1873-2518

pii

S0264-410X(13)01503-X

journal_volume

32

pub_type

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