Cover Image

PAPERBACK
$43.50



View/Hide Left Panel

TABLE D-5.3 Morbidity and Mortality due to Primary Hepatocellular Carcinoma

 

Population at Risk (millions)

Incidence Rate (per 100,000)

Number of Cases=Number of Deaths

High HBV Risk

 

 

 

South and east Asia

1,516

20

303,200

Sub-Saharan Africa

407

30

122,100

Oceania

5

10

500

Moderate HBV Risk

 

 

 

Central Asia

1,146

10

114,600

North Africa

124

10

12,400

South America

397

5

19,850

Total

 

 

572,650

 

SOURCE: Francis, personal communication, 1985.

Cirrhosis

Incidence rates of cirrhosis as a complication of hepatitis B have not been well documented. Beasley et al. (1981) found in Taiwan that for every death due to PHC there were 0.43 deaths from HBsAg-positive cirrhosis. This rate was applied to all PHC deaths. Cirrhosis deaths were assumed to equal 25 percent of cirrhosis cases. Cirrhosis cases were assigned to category E. Table D-5.5 shows the disease burden estimates for cirrhosis resulting from hepatitis B. Table D-5.6 shows the total disease burden estimates for hepatitis B.

PROBABLE VACCINE TARGET POPULATION

In highly endemic areas, the goal of HBV vaccination is to prevent both infection and the chronic carrier state. Because most population members of these areas are at risk of infection, universal vaccination is required. Furthermore, infection in these areas often occurs early in life, so the age of immunization must be adjusted accordingly. For areas of the world where perinatal infection is common, the first dose of vaccine should be given at birth (with the addition of hepatitis B immunoglobulin [HBIG] if vaccine alone is not effective in preventing perinatal infection) and subsequent doses delivered later. This approach is practical in many Asian countries because a substantial proportion of mothers deliver their infants in medical facilities. For areas of the world where perinatal infection is not a major problem, vaccination could be given simultaneously with other infant vaccinations. Thus, HBV vaccination could be incorporated into the World Health Organization Expanded Program on Immunization (WHO-EPI), with administration at the earliest current time of vaccine delivery.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement