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Neonatal HBV vaccine reduced liver disease risk in Chinese adults

Children in China who received the hepatitis B virus infection vaccination at birth had a reduced risk for primary liver cancer and other liver diseases when reaching young adulthood, according to new study data.

Researchers in China, including Chunfeng Qu, MD, PhD, of the State Key Laboratory of Molecular Oncology and Chinese Academy of Medical Sciences & Peking Union Medical College in Beijing, analyzed data collected from the Qidong Hepatitis B Intervention Study, a cluster randomized trial conducted between 1985 and 1990 in Qidong, China. The study included 39,292 newborns randomly assigned an HBV vaccination series and 34,441 newborns assigned placebo or no vaccination.

Of all the newborns in the HBV vaccination group, 38,366 completed the vaccination series. Sixty-seven percent of patients in the placebo group (n=23,368) received a catch-up vaccination for HBV at age 10 to 14 years.

By 2013, 10% of the vaccination series group and 11.3% of the control group were lost to follow-up. Researchers collected new data on liver disease mortality and primary liver cancer (PLC) incidence of the remaining patients through December 2013, from a population-based tumor registry.

Analyses showed patients in the vaccination group to have a lower PLC incidence rate (HR=0.16; 95% CI, 0.03-0.77) and an 84% efficacy rate for protecting against HBV-related PLC before age 30 years; a lower mortality rate of severe end-stage chronic liver diseases (HR=0.3; 95% CI, 0.11-0.85) and 70% efficacy rate for protecting against them; and lower infant fulminant hepatitis mortality (HR=0.31; 95% CI, 0.15-0.66) and a 69% efficacy rate against it, compared with the placebo group.

The catch-up HBV vaccine was less effective in lowering hepatitis B surface antigen seroprevalence in early adulthood compared with the vaccinated group (21% vs. 72%), according to the research. Patients who received the vaccine at age 10 to 14 years had decreased HBsAg seroprevalence if they were born to mothers positive for HBsAg (HR=0.68; 95% CI, 0.47-0.97).

“Neonatal HBV vaccination significantly decreased HBsAg seroprevalence in childhood through young adulthood and subsequently reduced the risk of PLC and other liver diseases in young adults,” the researchers wrote. “Our results also suggest that an adolescence booster should be considered in people who were born to HBsAg-positive mothers and completed HBV neonatal vaccination series.”

Disclosure: The study was funded through grants from the State Key Projects Specialized on Infection Diseases, Program Project of China and the National Institutes of Health.