Impact of the National Perinatal Hepatitis B Prevention Programme in the Republic of Korea: A retrospective registry-based cohort study. Issue 34 (22nd July 2020)

• Record Type: Journal Article
• Authors: Yang, Tae Un; Jung, Chae Won; Kim, Dongwook; Park, Hang A; Jee, Youngmee
• Is Part Of: Vaccine. Volume 38:Issue 34(2020)
• Page Start: 5532
• Page End: 5540
• Publication Date: 2020-07-22
• Subjects: Hepatitis B vaccine -- Mother-to-child transmission -- Hepatitis B -- Immunisation programme -- Impact -- Immunoprophylaxis; anti-HBs antibody to HBsAg -- HepB hepatitis B (disease) -- HBeAg Hepatitis B e antigen -- HBIg hepatitis B immune globulin -- HBsAg hepatitis B surface antigen -- HBV hepatitis B virus -- HepB-BD hepatitis B vaccine birth dose -- OR odds ratio -- CI confidence interval -- IHIS Integrated Health Information System -- IRR incidence rate ratio -- KCDC Korea Centres for Disease Control and Prevention -- KNHANES Korea National Health and Nutrition Examination Survey -- MTCT mother-to-child transmission -- NHI National Health Insurance -- NIP national immunisation programme -- PEI post-exposure immunoprophylaxis -- PHBPP Perinatal Hepatitis B Prevention Programme -- PHBPP-IS Perinatal Hepatitis B Prevention Programme Information System -- PHC public health centre -- PVST post-vaccination serologic test -- ROK Republic of Korea -- WUNEIC World Health Organization-United Nations Children's Fund National Estimate of Immunization Coverage; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2020.05.044
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: The Republic of Korea has a successful perinatal hepatitis B prevention programme. Hepatitis B-exposed infants are vaccinated and given immune globulin at birth. Hepatitis B virus transmission was prevented in >14, 000 infants in 11.5 years. The cost was 1157 US dollars per case averted. The incidence of paediatric hepatocellular carcinoma dropped to very low levels. Abstract: Introduction: Hepatitis B is a major preventable cause of morbidity and mortality from chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. We aimed to evaluate the performance and outcomes of the Korean Perinatal Hepatitis B Prevention Programme (PHBPP) and to investigate the impact of the current post-exposure immunoprophylaxis protocol. Methods: A retrospective cohort study was performed based on electronic data registry of infants born to hepatitis B virus (HBV)-infected mothers between July 2002 and 2013. Results: During the study period, 159, 983 Korean infants were registered with the PHBPP, with an overall programme coverage of 92.8%. Despite receiving timely post-exposure immunoprophylaxis, 8.6% of infants born to mothers aged <25 years and hepatitis B e antigen (HBeAg)-positive, and 0.7% of infants born to mothers aged ≥25 years and HBeAg-negative were infected. An estimated 14, 123 infants were directly protected from perinatal HBV transmission by the PHBPP during the 11.5-year period, at a cost of 1157 US dollars per case averted. The incidence of paediatric hepatocellular carcinoma declined dramatically during the period. Conclusions: A substantial number of infants have been prevented from hepatitis B since the PHBPP was launched in the Republic of Korea. Continued efforts to promote the programme, an integrated approach to maximising its coverage, a risk-stratified strategy, and innovations in logistics could further reduce perinatal HBV transmission.