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HEPATITIS B INFECTION IN RURAL VIETNAM AND THE IMPLICATIONS FOR A NATIONAL PROGRAM OF INFANT IMMUNIZATION

To ascertain hepatitis B virus (HBV) infection rates for Vietnam, we surveyed HBV markers in two districts of Thanh Hoa province. We randomly selected 536 infants (9– 18 months old), 228 children (4 to 6 years old), 219 adolescents (14 to 16 years old), and 596 adults (25 to 40 years old). On questioning, none of those surveyed had received vaccine against HBV. Hepatitis B virus surface antigen (HBsAg) and total HBV core antibody (anti-HBc) were measured in all specimens, and HBV e antigen (HBeAg) in those positive for HBsAg, and HBV surface antibody (anti-HBs) were measured in all others. Current infection (HBsAg+) rates were infants = 12.5%, children = 18.4%, adolescents = 20.5%, and adults = 18.8%. Current or previous infection (HBsAg+, anti-HBc+, or anti-HBs+) increased with age (infants = 19.6%, children = 36.4%, adolescents = 55.3%, adults = 79.2%). Rates of HBeAg among those HBsAg+ were infants = 85.1%, children = 88.1%, adolescents = 71.1%, and adults = 30.4%. The epidemiology of HBV in Vietnam resembles that of many southeast Asian nations before introduction of vaccine. Immunization of newborns will have enormous impact on HBV-related morbidity and mortality there.

Received September 17, 2002. Accepted for publication May 7, 2003.

Acknowledgments: We gratefully acknowledge the assistance of Associate Professor Stephen Locarnini, Alan Breschkin and the scientists at NIHE and VIDRL, the staffs at NIHE and the Quang Xuong and Ngoc Lac District Health Services, and Gill Mayers (World Health Organization, Geneva, Switzerland). We also thank Dr. Karl Jenkinson (University of Melbourne) for assistance in manuscript preparation.

Financial support: This study was supported by the Australian Agency for International Development as part of a broader primary health care project entitled "Strengthening Immunisation and Malaria Control in Vietnam".

Authors’ addresses: David B. Hipgrave, Vu Minh Huong, Tran Nam Trung, and James E Maynard, Program for Appropriate Technology in Health, Box 252, International Post Office, Hanoi, Vietnam. Nguyen Thu Van, Hoang Thuy Long, and Do Tuan Dat, National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi 10000, Vietnam. Damien Jolley, School of Health Sciences, Deakin University, 221 Burwood Highway, Burwood 3125, Australia. Beverley-Ann Biggs, Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville 3052, Australia, Telephone: 61-3-8344-6252, Fax: 61-3-9347-1863, E-mail: babiggs{at}unimelb.edu.au

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