Forum

Preventing hepatitis B and hepatocellular carcinoma in South Africa: The case for a birth-dose vaccine

C W N Spearman, Mark W Sonderup

Abstract


Hepatitis B is a global public health issue, with some 2 billion people having current or past infection. In Africa, 65 million are chronically infected, an estimated 2.5 million of them in South Africa (SA). Hepatitis B and the associated complications of cirrhosis and hepatocellular carcinoma are entirely vaccine preventable. SA was one of the first ten countries in Africa to introduce universal hepatitis B vaccination in April 1995, but has no birth dose or catch-up programme. Although universal infant vaccination in SA has been successful in increasing population immunity to hepatitis B, improvements in terms of implementing protocols to screen all pregnant mothers for hepatitis B surface antigen (HBsAg) and ensuring full hepatitis B coverage, especially in rural areas, is justified. The World Health Organization has recommended a birth dose of hepatitis B vaccine in addition to the existing hepatitis B vaccine schedule in order to further decrease the risk of perinatal transmission. We recommend that SA implement a birth-dose vaccine into the existing schedule to attenuate the risk of perinatal transmission, prevent breakthrough infections and decrease HBsAg carriage in babies born to HIV-positive mothers.


Authors' affiliations

C W N Spearman, Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Mark W Sonderup, Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Full Text

PDF (87KB) HTML

Keywords

Hepatitis B; Vaccine; Hepatocellular carcinoma

Cite this article

South African Medical Journal 2014;104(9):610-612. DOI:10.7196/SAMJ.8607

Article History

Date submitted: 2014-06-26
Date published: 2014-07-25

Article Views

Abstract views: 5581
Full text views: 5932

Comments on this article

*Read our policy for posting comments here