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

DAVID B. HIPGRAVEInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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NGUYEN THU VANInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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VU MINH HUONGInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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HOANG THUY LONGInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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DO TUAN DATInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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TRAN NAM TRUNGInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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DAMIEN JOLLEYInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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JAMES E. MAYNARDInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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BEVERLEY-ANN BIGGSInternational Health Unit, The Burnet Institute, Alfred Medical Research & Education Precinct, Melbourne, Australia; Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, Australia; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam; School of Health Sciences, Deakin University, Burwood, Australia

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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.

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