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  1. NTU Scholars
  2. 醫學院
  3. 醫學系
Please use this identifier to cite or link to this item: https://scholars.lib.ntu.edu.tw/handle/123456789/537029
Title: Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: A 20-year follow-up study
Authors: MEI-HWEI CHANG 
You S.-L.
Chen C.-J.
CHUN-JEN LIU 
Lee C.-M.
Lin S.-M.
Chu H.-C.
Wu T.-C.
Yang S.-S.
Kuo H.-S.
DING-SHINN CHEN 
Issue Date: 2009
Journal Volume: 101
Journal Issue: 19
Start page/Pages: 1348-1355
Source: Journal of the National Cancer Institute
Abstract: 
Background Hepatitis B virus (HBV) infection is a major cause of hepatocellular carcinoma. This population-based study aimed to investigate whether prevention of hepatocellular carcinoma by the universal Taiwanese HBV vaccine program, launched in July 1984, has extended beyond childhood and to identify the predictors of hepatocellular carcinoma for vaccinated birth cohorts.MethodsData on 1958 patients with hepatocellular carcinoma who were aged 6-29 years at diagnosis in Taiwan between 1983 and 2004 were collected from two national hepatocellular carcinoma registries. Age-and sex-specific incidence among vaccinated and unvaccinated birth cohorts were analyzed by using Poisson regression models. All statistical tests were two-sided. Records of 64 hepatocellular carcinoma patients and 5524435 HBV vaccinees who were born after the initiation of the vaccination program were compared for HBV immunization characteristics during infancy and prenatal maternal hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) serostatus.ResultsHepatocellular carcinoma incidence was statistically significantly lower among children aged 6-19 years in vaccinated compared with unvaccinated birth cohorts (64 hepatocellular cancers among vaccinees in 37709304 person-years vs 444 cancers in unvaccinated subjects in 78496406 person-years, showing an age-and sex-adjusted relative risk of 0.31, P <. 001, for persons vaccinated at birth). The risk of developing hepatocellular carcinoma for vaccinated cohorts was statistically significantly associated with incomplete HBV vaccination (for those who received fewer than three doses of HBV vaccine, odds ratio [OR] = 4.32, 95% confidence interval [CI] = 2.34 to 7.91); with prenatal maternal HBsAg seropositivity (OR = 29.50, 95% CI = 13.98 to 62.60); with prenatal maternal HBeAg seropositivity (with administration of hepatitis B immunoglobulin at birth, OR = 5.13, 95% CI = 2.24 to 11.71; and without it, OR = 9.43, 95% CI = 3.54 to 25.11).ConclusionThe prevention of hepatocellular carcinoma by this HBV vaccine extends from childhood to early adulthood. Failure to prevent hepatocellular carcinoma results mostly from unsuccessful control of HBV infection by highly infectious mothers.
URI: https://www.scopus.com/inward/record.uri?eid=2-s2.0-70349939381&doi=10.1093%2fjnci%2fdjp288&partnerID=40&md5=e607ec8fb232c0c21050a3d731b078a1
https://scholars.lib.ntu.edu.tw/handle/123456789/537029
ISSN: 0027-8874
DOI: 10.1093/jnci/djp288
SDG/Keyword: hepatitis B surface antigen; hepatitis B vaccine; hepatitis B(e) antigen; adult; article; child; controlled study; female; follow up; health program; hepatitis B; human; incidence; liver cell carcinoma; major clinical study; male; perinatal infection; preschool child; priority journal; risk factor; sex difference; Taiwan; Adolescent; Adult; Age Distribution; Carcinoma, Hepatocellular; Child; Female; Follow-Up Studies; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis B Vaccines; Humans; Incidence; Liver Neoplasms; Male; Mothers; Multivariate Analysis; Odds Ratio; Registries; Sex Distribution; Taiwan; Young Adult
[SDGs]SDG3
Appears in Collections:醫學系

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