Cancer Prevention by Vaccination Against Hepatitis B

Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 181)

Abstract

Chronic inflammation caused by persistent infection is closely related to a number of cancers; these include hepatitis B (HBV) or C and hepatoma, human papilloma virus and cervical cancer, and Helicobacter pylori and gastric cancer. The first evidence of cancer prevention by vaccination in humans was provided by HBV vaccination in infants. Chronic HBV is related to approximately 60%–90% of hepatocellular carcinomas (HCC) in adults and nearly 100% of childhood HCC in areas endemic for HBV infection. The first universal HBV vaccination program was launched in Taiwan and has continued for more than 20 years. Three or four doses of HBV vaccine were given to all infants starting from the first week of life. In addition, infants of high-risk mothers (with positive hepatitis B e antigen or high HBsAg titers) were given hepatitis B immunoglobulin within 24 h after birth. At 20 years after the launch of the HBV vaccination program in Taiwan, chronic HBV infection (HBsAg seropositive) rates in the general population below 20 years of age have revealed a remarkable reduction from 10%–17% before the vaccination program to 0.7%–1.7% after the program. HCC incidence rate in children 6–14 years old also fell from 0.52–0.54 to 0.13–0.20 per 100,000 (R.R.=0.25–0.36). HCC prevention failure is mainly related to vaccine failure to prevent chronic HBV infection. The causes of vaccine failure have included intrauterine infection, vaccine escape mutants, genetic hyporesponsive-ness, and poor compliance. Future efforts to reduce vaccine failure will improve the efficacy of liver cancer prevention by HBV vaccination. The experience of HCC prevention by HBV immunization may be applied to the prevention of other infection-related cancers.

Keywords

Vaccine Failure Universal Hepatitis Central Nervous System Demyelinating Disease Infectious Mother 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Beasley R P, Hwang LY, Lin CC, Chien CS (1981) Hepatocellular carcinoma and hepatitis B virus: a prospective study of 22,707 men in Taiwan. Lancet 2:1129–1133PubMedCrossRefGoogle Scholar
  2. Beasley R P, Hwang LY, Lin CC, et al (1982) Incidence of hepatitis B virus infection in preschool children in Taiwan. J Infect Dis 146:198–204PubMedGoogle Scholar
  3. Beasley R P, Hwang LY, Lin CC, et al (1983a) Incidence of hepatitis among students at a university in Taiwan. Am J Epidemiol 117:213–222Google Scholar
  4. Beasley RP, Hwang LY, Lee GCY, et al (1983b) Prevention of perinatally transmitted hepatitis B virus infection with hepatitis B immune globulin and hepatitis B vaccine. Lancet 2:1099–1202CrossRefGoogle Scholar
  5. Camma C, Giunta M, Andreone P, Craxi A (2001) Interferon and prevention of hepatocellular carcinoma in viral cirrhosis: an evidence-based approach. J Hepatol 34:593–602PubMedCrossRefGoogle Scholar
  6. Chang MH, Chen DS, Hsu HC, Hsu HY, Lee CY (1989) Maternal transmission of hepatitis B virus in childhood hepatocellular carcinoma. Cancer 64:2377–2380PubMedCrossRefGoogle Scholar
  7. Chang MH, Chen PJ, Chen J Y, et al (1991) Hepatitis B virus integration in hepatitis B virus-related hepatocellular carcinoma in childhood. Hepat-ology 13:316–320CrossRefGoogle Scholar
  8. Chang MH, Lee CY, Chen DS (1993) Minimal role of hepatitis C virus infection in childhood liver diseases in an area hyperendemic for hepatitis B infection. J Med Virol 40:322–325PubMedCrossRefGoogle Scholar
  9. Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, Liang DC, Shau WY, Chen DS (1997) Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. N Engl J Med 336:1855–1859PubMedCrossRefGoogle Scholar
  10. Chang MH, Shau WY, Chen CJ, et al (2000) The effect of universal hepatitis B vaccination on hepatocellular carcinoma rates in boys and girls. JAMA 284:3040–3042PubMedCrossRefGoogle Scholar
  11. Chang MH, Chen T, Hsu HM, et al (2005) Problems in the prevention of childhood hepatocellular carcinoma in the era of universal hepatitis B immunization. Clin Cancer Res 11:7953–7957PubMedCrossRefGoogle Scholar
  12. Chen DS, Hsu NHM, Sung JL, et al (1987) Mass vaccination program in Taiwan against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers. JAMA 257:2597–2603PubMedCrossRefGoogle Scholar
  13. Chen HL, Chang MH, Ni YH, et al (1996) Seroepidemiology of hepatitis B virus infection in children—ten years of mass vaccination in Taiwan. JAMA 276:906–908PubMedCrossRefGoogle Scholar
  14. Chuang SE, Kuo ML, Hsu CH, et al (2000) Curcumin-containing diet inhibits diethylnitro-samine-induced murine hepatocarcinogenesis. Carcinogenesis 21:331–335PubMedCrossRefGoogle Scholar
  15. Egner PA, Wang JB, Shu YR, et al (2001) Chlorophyllin intervention reduces aflatoxin-DNA adducts in individuals at high risk for liver cancer. Proc Natl Acad Sci U S A 98:14601–14606PubMedCrossRefGoogle Scholar
  16. Halsey NA, Duclos P, van Damme P, et al (1999) Hepatitis B vaccine and central nervous system demyelinating diseases. Pediatr Infect Dis J 18:23–24PubMedCrossRefGoogle Scholar
  17. Hold GL, El-Omar ME (2008) Genetic aspects of inflammation and cancer. Biochem J 410:225–235PubMedCrossRefGoogle Scholar
  18. Hsu HM, Chen DS, Chuang CH, et al (1988) Efficacy of a mass hepatitis B vaccination program in Taiwan: studies on 3464 infants of hepatitis B surface antigen-carrier mothers. JAMA 260:2231–2235PubMedCrossRefGoogle Scholar
  19. Hsu HY, Chang MH, Chen DS, et al (1986) Baseline seroepidemiology of hepatitis B virus infection in children in Taipei, 1984: a study just before mass hepatitis B vaccination program in Taiwan. J Med Virol 18:301–307PubMedCrossRefGoogle Scholar
  20. Hsu HY, Chang MH, Ni YH, Chen HL (2004) Survey of hepatitis B surface variant infection in children 15 years after a nationwide vaccination programme in Taiwan. Gut 53:1499–1503PubMedCrossRefGoogle Scholar
  21. Kersler TW, Egner PA, Wang JB, et al (2004) Chemoprevention of hepatocellular carcinoma in aflatoxin endemic areas. Gastroenterology 127[Suppl 1]:S310–S318CrossRefGoogle Scholar
  22. Larouze B, Saimot G, Lustbader ED, London WT, Werner BG, Payet M (1976) Host response to hepatitis B infection in patients with primary hepatic carcinoma and their families: a case control study in Senegal, West Africa. Lancet 2:534–538PubMedCrossRefGoogle Scholar
  23. Liaw YF, Sung JJ, Chow WC, et al (2004) Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med 351:1521–1531PubMedCrossRefGoogle Scholar
  24. Moriwaki H, Shimizu M, Okuno M, Nishiwaki-Matsushima R (2007) Chemoprevention of liver carcinogenesis with retinoids: basic and clinical aspects. Hepatol Res 37[Suppl 2]:S299–302PubMedCrossRefGoogle Scholar
  25. Ni YH, Chang MH, Hsu HY, et al (1991) Hepatocellular carcinoma in childhood: clinical manifestations and prognosis. Cancer 68:1737–1741PubMedCrossRefGoogle Scholar
  26. Ni YH, Chang MH, Huang LM, et al (2001) Hepatitis B virus infection in children and adolescents in a hyperendemic area: 15 years after universal hepatitis B vaccination. Ann Intern Med 135:769–800Google Scholar
  27. Ni YH, Huang LM, Chang MH, et al (2007) Two decades of universal hepatitis B vaccination in Taiwan: impact and implication for future strategies. Gastroenterology 132:1287–1293PubMedCrossRefGoogle Scholar
  28. Parkin DM, Bray F, Ferlay J, Pisani P (2001) Estimating the world cancer burden: Globocan. Int J Cancer 94:153–156PubMedCrossRefGoogle Scholar
  29. Poovorawan Y, Sanpavat S, Pongpunlert W, Chumdermpadetsuk S, Sentrakul P, Sarary A (1989) Protective efficacy of a recombinant DNA hepatitis B vaccine in neonates of HBe antigen-positive mothers. JAMA 261:3278–3281PubMedCrossRefGoogle Scholar
  30. Popper H, Gerber MA, Thung SN (1982) The relation of hepatocellular carcinoma to infection with hepatitis B and related viruses in man and animals. Hepatology 2[Suppl]:1S–9SGoogle Scholar
  31. Ryder RW, Whittle HC, Sanneh ABK, Ajdukiewicz AB, Tulloch S, Yvonnet B (1992) Persistent hepa-titis B virus infection and hepatoma in the Gambia, West Africa. Am J Epidemiol 136:1122–1131PubMedGoogle Scholar
  32. Shepard C W, Simard E P, Finelli L, Fiore A F, Bell BP (2006) Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 28:112–125PubMedCrossRefGoogle Scholar
  33. Stevens CE, Beasley R P, Tsui J, Lee WC (1975) Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med 292:771–774PubMedGoogle Scholar
  34. Tanaka H, Tukma H, Kasahara A, et al (2000) Effect of interferon therapy on the incidence of hepato-cellular carcinoma and mortality of patients with chronic hepatitis C: a retrospective cohort study of 738 patients. Int J Cancer 87:741–749PubMedCrossRefGoogle Scholar
  35. Tandon BN, Tandon A (1997) Epidemiological trends of viral hepatitis in Asia. In: Rizzetto M, Purcell RH, Gerin JL, Verme G (eds) Viral hepatitis and liver disease. Edizioni Minera Medica, Turin, pp 559–561Google Scholar
  36. Tang JR, Hsu HY, Lin HH, Ni YH, Chang MH (1998) Hepatitis B surface antigenemia at birth: a long-term follow-up study. J Pediatr 133:374–377PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  1. 1.National Taiwan University HospitalTaipei

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