A Study on Prognosis of Acute Hepatitis B in Hepatitis B Vaccinated Cohort
Chia-Ling Liu1, Ji-Jia Huang1, Szu-Fong Lin2, Jyh-Yuan Yang2, Wei-Ju Su1, Ding-Ping Liu3
2014 Vol.30 NO.14
Correspondence Author： Chia-Ling Liu
Taiwan initiated the implementation of national neonatal hepatitis B vaccination program in July 1986. This retrospective study on the epidemiological characteristics and prognosis of acute hepatitis B in the hepatitis B vaccinated cohort aims to provide background for prospective hepatitis B prevention and control policy-making. Identified from the Taiwan Centers for Disease Control Notifiable Disease Surveillance System (NDSS) database, 75 acute hepatitis B patients, born after July 1, 1986 and diagnosed between January 1, 2008 and March 31, 2012, were approached. After voluntary recruitment, the participants underwent a hepatitis B serum marker test and completed a questionnaire. The participants' family members were also tested for hepatitis B carriage status. Thirty-seven eligible patients (37/75, 49.3%) consented to the study, among whom 81.1% (30/37) received at least three doses, while those who had incomplete vaccination series or no vaccination record were mostly born between 1987 and 1990. Nine participants (9/37, 24.3%) had a family history of hepatitis B carriage, while no one had hepatitis B carrier siblings. The most common age of disease onset was 15-24 (N=32), among whom six were married to/ in partnership with a hepatitis B carrier. Second most common age of disease onset was under 1 (N=3), of whom all were born to hepatitis B carrier mothers. Prognosis based on hepatitis B serum marker profiles showed that HBsAg disappeared and Anti-HBs appeared in 21 participants (21/37, 56.8%), HBsAg disappeared without Anti-HBs appeared in 12 participants (12/37, 32.4%), 3 participant became hepatitis B carriers (3/37, 8.1%) whose age of hepatitis B disease onset was 8 months, 6 years and 19 years old respectively, and 1 participant died of fulminant hepatic failure in acute hepatitis B. This survey shows that the prognosis of acute hepatitis B patients of the hepatitis B vaccinated cohort is not always clearance of HBsAg in conjunction with appearance of Anti-HBs. Regarding the prevention and control of acute hepatitis B, except for certain reasons and mother-to-infant perinatal transmission which can not be fully prevented with vaccination, the disease risk is still present among the 15-24 age group. Therefore, work remains to be done on developing hepatitis prevention and control strategies for this group in order to achieve the target of hepatitis B elimination.