Early Hepatitis B Vaccination May Prevent Liver Cancer

It is estimated that 100,000 to 150,000 people acquire the hepatitis B virus every year in the United States.

Once a person is infected with the virus, they have an increased risk of developing a type of liver cancer called hepatocellular carcinoma. In fact, up to 80% of hepatocellular carcinoma cases worldwide are directly attributable to hepatitis B. Fortunately, there is a vaccine against hepatitis B, making the virus and its associated development of hepatocellular carcinoma preventable. Results from a recent report published in the

Journal of the American Medical Association indicate that compliance with the hepatitis B vaccination series is achieved at a higher rate when infants receive their first vaccination within the first seven days of life.

The most common type of liver cancer, hepatocellular carcinoma, is characterized by cancer that starts in cells of the liver and can spread through blood and lymph vessels to different parts of the body. The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins and fats, the production of bile, the processing of hemoglobin and the detoxification of numerous substances.

In the United States, there has been a nationwide attempt to vaccinate all infants against hepatitis B. The vaccine involves a series of three doses. The preferred immunization schedule calls for the initial vaccination to be administered within the first seven days of life, the second dose at one to two months of age, and the third dose at six to eighteen months of age. Alternate schedules involve the administration of the initial dose at a later time in an infant’s life with appropriate waiting periods between subsequent doses.

In a recent study, researchers have attempted to determine if the time of initiation of vaccination affects the compliance of completing the hepatitis B vaccination series. Overall, 87% of children in the survey completed the entire vaccination schedule. However, infants that received their initial dose within the first seven days of life had a higher compliance rate compared with the infants who had delayed the initiation of the series. Importantly, results showed that the longer the delay of receiving the first dose of the vaccination series, the less likely the infant was to receive all three doses of the vaccine.

These observations indicate that the first dose of hepatitis B vaccine series should be administered shortly after birth, preferably before discharge from the hospital. Universal infant hepatitis B vaccination is the most important component of the overall strategy to eliminate hepatitis B transmission in the United States. In association to the prevention of hepatitis B infection, the majority of hepatocellular carcinoma cases in the United States may be significantly decreased. (Journal of the American Medical Association, Vol 284, No 8, pp 978-983, 2000)

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