Volume 69, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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.


Article metrics loading...

Loading full text...

Full text loading...



  1. Wittet S, 2000. Introducing GAVI and the Global Fund for Children’s Vaccines. Vaccine 19 : 385–386.
  2. Beasley RP, Hwang LY, Lin CC, Stevens CE, Wang KY, Sun TS, Hsieh FJ, Szmuness W, 1981. Hepatitis B immune globulin (HBIG) efficacy in the interruption of perinatal transmission of hepatitis B virus carrier state. Initial report of a randomised double-blind placebo-controlled trial. Lancet 2 : 388–393.
  3. Maynard JE, Kane MA, Hadler SC, 1989. Global control of hepatitis B through vaccination: role of hepatitis B vaccine in the Expanded Programme on Immunization. Rev Infect Dis 11 (Suppl 3): 574–578.
  4. Yao JL, 1996. Perinatal transmission of hepatitis B virus infection and vaccination in China. Gut 38 : 37–38.
  5. Poovorawan Y, Sanpavat S, Pongpunglert W, Chumdermpadetsuk S, Sentrakul P, Vandepapeliere P, Safary A, 1992. Long term efficacy of hepatitis B vaccine in infants born to hepatitis B e antigen-positive mothers. Pediatr Infect Dis J 11 : 816–821.
  6. Andre FE, Zuckerman AJ, 1994. Review: protective efficacy of hepatitis B vaccines in neonates. J Med Virol 44 : 144–151.
  7. Huang K, Lin S, 2000. Nationwide vaccination: a success story in Taiwan. Vaccine 18 : 35–38.
  8. Kao JH, Hsu HM, Shau WY, Chang MH, Chen DS, 2001. Universal hepatitis B vaccination and the decreased mortality from fulminant hepatitis in infants in Taiwan. J Pediatr 139 : 349–352.
  9. Hsu HY, Chang MH, Chen DS, Lee CY, Sung JL, 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 : 301–307.
  10. Hsu HM, Chen DS, Chuang CH, Lu JC, Jwo DM, Lee CC, Lu HC, Cheng SH, Wang YF, Wang CY, Lo KJ, Shih CJ, Sung JL, 1988. Efficacy of a mass hepatitis B vaccination program in Taiwan. Studies on 3,464 infants of hepatitis B surface antigen-carrier mothers. JAMA 260 : 2231–2235.
  11. Tran VB, Buu M, Nguyen TM, Morris GE, 1993. Hepatitis B in Ho Chi Minh City, Viet Nam. Trans R Soc Trop Med Hyg 87 : 262.
  12. Nakata S, Song P, Duc DD, Nguyen XQ, Murata K, Tsuda F, Okamoto H, 1994. Hepatitis C and B virus infections in populations at low or high risk in Ho Chi Minh and Hanoi, Vietnam. J Gastroenterol Hepatol 9 : 416–419.
  13. Katelaris PH, Robertson G, Bradbury R, Tippett G, Hoa DQ, Ngu MC, 1995. Seroprevalence of hepatitis viruses in children in rural Viet Nam. Trans R Soc Trop Med Hyg 89 : 487.
  14. Lee PI, Lee CY, Huang LM, Chang MH, 1995. Long-term efficacy of recombinant hepatitis B vaccine and risk of natural infection in infants born to mothers with hepatitis B e antigen. J Pediatr 126 : 716–721.
  15. McMahon BJ, Alward WL, Hall DB, Heyward WL, Bender TR, Francis DP, Maynard JE, 1985. Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis 151 : 599–603.
  16. Roumeliotou-Karayannis A, Tassopoulos N, Richardson SC, Kalafatas P, Papaevangelou G, 1985. How often does chronic liver disease follow acute hepatitis B in adults? Infection 13 : 174–176.
  17. Edmunds WJ, Medley GF, Nokes DJ, Hall AJ, Whittle HC, 1993. The influence of age on the development of the hepatitis B carrier state. Proc R Soc Lond B Biol Sci 253 : 197–201.
  18. Hyams KC, 1995. Risks of chronicity following acute hepatitis B virus infection: a review. Clin Infect Dis 20 : 992–1000.
  19. Milne A, Allwood GK, Moyes CD, Pearce NE, Lucas CR, 1985. Prevalence of hepatitis B infections in a multiracial New Zealand community. N Z Med J 98 : 529–532.
  20. Franks AL, Berg CJ, Kane MA, Browne BB, Sikes RK, Elsea WR, Burton AH, 1989. Hepatitis B virus infection among children born in the United States to Southeast Asian refugees. N Engl J Med 321 : 1301–1305.
  21. Alter MJ, Hadler SC, Margolis HS, Alexander WJ, Hu PY, Judson FN, Mares A, Miller JK, Moyer LA, 1990. The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. JAMA 263 : 1218–1222.
  22. Goh KT, 1997. Prevention and control of hepatitis B virus infection in Singapore. Ann Acad Med Singapore 26 : 671–681.
  23. Centers for Disease Control, 1991. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Morb Mortal Wkly Rep 40 : 1–25.
  24. American Academy of Pediatrics Committee on Infectious Diseases, 1992. Universal hepatitis B immunization. Pediatrics 89 : 795–800.
  25. World Health Organization, 1992. Expanded program on immunization. Global Advisory Group—Part 1. Wkly Epidemiol Rec 67 : 11–15.
  26. Ghendon Y, 1987. Perinatal transmission of hepatitis B virus in high-incidence countries. J Virol Methods 17 : 69–79.
  27. Gust ID, 1996. Epidemiology of hepatitis B infection in the Western Pacific and South East Asia. Gut 38 : 18–23.
  28. Mahoney FJ, Kane M, 1999. Hepatitis B vaccine. Plotkin, SA, Orenstein, W, eds. Vaccines. Third edition. Philadelphia: W. B. Saunders Co., 158–181.
  29. Chu CM, Sheen IS, Lin SM, Liaw YF, 1993. Sex difference in chronic hepatitis B virus infection: studies of serum HBeAg and alanine aminotransferase levels in 10,431 asymptomatic Chinese HBsAg carriers. Clin Infect Dis 16 : 709–713.
  30. Beasley RP, Trepo C, Stevens CE, Szmuness W, 1977. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol 105 : 94–98.
  31. Pongpipat D, Suvatte V, Assateerawatts A, 1985. Perinatal transmission of hepatitis B virus in Thailand. Asian Pac J Allergy Immunol 3 : 191–193.
  32. Lo KJ, Tsai YT, Lee SD, Wu TC, Wang JY, Chen GH, Yeh CL, Chiang BN, Yeh SH, Goudeau A, Coursaget P, Tong MJ, 1985. Immunoprophylaxis of infection with hepatitis B virus in infants born to hepatitis B surface antigen-positive carrier mothers. J Infect Dis 152 : 817–822.
  33. Smego RA Jr, Halsey NA, 1987. The case for routine hepatitis B immunization in infancy for populations at increased risk. Pediatr Infect Dis J 6 : 11–19.
  34. http://www.vaccinealliance.org/press/press_release3105.html.
  35. Goudeau A, Lo KJ, Coursaget P, Tong MJ, Yeh CL, Tsai YT, Lee JK, Wu TC, Yeh SH, Lee SD, 1983. Prevention of hepatitis B virus infection in children born to HBsAg positive/HBeAg positive mothers. Preliminary results of active and passive-active immunization. Dev Biol Stand 54 : 399–404.
  36. Ruff TA, Gertig DM, Otto BF, Gust ID, Sutanto A, Soewarso TI, Kandun N, Marschner IC, Maynard JE, 1995. Lombok Hepatitis B Model Immunization Project: toward universal infant hepatitis B immunization in Indonesia. J Infect Dis 171 : 290–296.
  37. Beasley RP, Hwang LY, 1984. Epidemiology of hepatocellular carcinoma. Vyas GN, Dienstag JL, Hoofnagle JH, eds. Viral Hepatitis and Liver Disease. New York: Gruen and Stratton, 209–224.
  38. Margolis HS, Coleman PJ, Brown RE, Mast EE, Sheingold SH, Arevalo JA, 1995. Prevention of hepatitis B virus transmission by immunization. An economic analysis of current recommendations. JAMA 274 : 1201–1208.
  39. Harpaz R, McMahon BJ, Margolis HS, Shapiro CN, Havron D, Carpenter G, Bulkow LR, Wainwright RB, 2000. Elimination of new chronic hepatitis B virus infections: results of the Alaska immunization program. J Infect Dis 181 : 413–418.
  40. Mahoney FJ, Woodruff BA, Erben JJ, Coleman PJ, Reid EC, Schatz GC, Kane MA, 1993. Effect of a hepatitis B vaccination program on the prevalence of hepatitis B virus infection. J Infect Dis 167 : 203–207.
  41. Wilson N, Ruff TA, Rana BJ, Leydon J, Locarnini S, 2000. The effectiveness of the infant hepatitis B immunisation program in Fiji, Kiribati, Tonga and Vanuatu. Vaccine 18 : 3059–3066.
  42. Yao GB, 1996. Importance of perinatal versus horizontal transmission of hepatitis B virus infection in China. Gut 38 : 39–42.
  43. Chunsuttiwat S, Biggs BA, Maynard J, Thamapalo S, Laoboripat S, Bovornsin S, Charanasri U, Pinyowiwat W, Kunasol P, 1997. Integration of hepatitis B vaccination into the expanded programme on immunization in Chonburi and Chiangmai provinces, Thailand. Vaccine 15 : 769–774.
  44. Al-Faleh FZ, Al-Jeffri M, Ramia S, Al-Rashed R, Arif M, Rezeig M, Al-Toraif I, Bakhsh M, Mishkkhas A, Makki O, Al-Freihi H, Mirdad S, AlJuma A, Yasin T, Al-Swailem A, Ayoola A, 1999. Seroepidemiology of hepatitis B virus infection in Saudi children 8 years after a mass hepatitis B vaccination programme. J Infect 38 : 167–170.
  45. Viviani S, Jack A, Hall AJ, Maine N, Mendy M, Montesano R,Whittle HC, 1999. Hepatitis B vaccination in infancy in The Gambia: protection against carriage at 9 years of age. Vaccine 17 : 2946–2950.
  46. Tsen YJ, Chang MH, Hsu HY, Lee CY, Sung JL,Chen DS, 1991. Seroprevalence of hepatitis B virus infection in children in Taipei, 1989: five years after a mass hepatitis B vaccination program. J Med Virol 34 : 96–99.

Data & Media loading...

  • Received : 17 Sep 2002
  • Accepted : 07 May 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error