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Western Pacific Region progressing toward HBV control, MTCT elimination

Between 2005 and 2017, countries in the Western Pacific Region achieved marked progress toward hepatitis B control and elimination of mother-to-child transmission through increased vaccination among newborns, according to a report from the CDC.

“Hepatitis B vaccine (HepB), which has been available since 1982, provides lifelong protection against hepatitis B virus (HBV) infection,” Joseph Woodring, DO, from the World Health Organization, and colleagues wrote. “Continued implementation of proven vaccination strategies will be needed to make further progress toward [Western Pacific Region (WPR)] hepatitis B control targets.”

Among the 36 countries that report HBV vaccination coverage annually to WHO and the United Nations Children’s Fund, the first HepB dose administered within 24 hours of birth increased from 63% to 85% and coverage of the third HepB dose increased from 76% to 93%. In 2017, 15 countries achieved a 95% or better birth dose coverage and 18 achieved a 95% or better third dose coverage.

In 1990, before HebB was implemented into childhood immunization schedules in most WPR countries, HBV surface antigen seroprevalence was estimated to be higher than 8% among children aged 5 years in 22 countries.

As of December 2017, seroprevalence among children aged 5 years declined to less than 1% in 25 countries based on national serosurveys including a rate of less than 0.5% in China. The Hepatitis B Immunization Expert Resource Panel verified that 19 of the 36 countries met the regional prevalence target of less than 1%.

In contrast, Laos, Papua New Guinea, Vietnam and several Pacific Island countries reported an estimated HBsAg prevalence of more than 2% in children aged 5 years.

As of December 2017, 19 countries developed national plans for viral hepatitis prevention and 20 countries developed a national policy for routine antenatal HBsAg testing. However, only two countries reported testing 95% or more pregnant women for HBsAg, and eight countries reported providing antivirals to infected mothers.

“The WPR has significantly decreased the incidence of chronic HBV infection, with a few countries still requiring programmatic improvement in vaccination to achieve hepatitis B control,” Woodring and colleagues wrote.

As the WPR expands implementation of interventions for elimination of mother-to-child transmission of HBV, the researchers advised that global and regional guidance will be required, including the use of monitoring indicators, the appropriate frequency of costly serosurveys, and the use of models to estimate infection prevalence. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.