STRATEGY FOR VACCINATION AGAINST HEPATITIS-B IN AREAS WITH HIGH ENDEMICITY - FOCUS ON KOREA

Hepatitis B vaccination strategies may vary from country to country de pending on hepatitis B virus (HBV) endemicity, predominant modes of in fection, age of infection, and health care resources. In areas with hi gh endemicity like Korea, transmission of virus from carrier mothers t o infants during the perinatal period, and from other horizontal sourc es to infants and children, account for most cases of HBV infection. T he consequences of HBV infection at an early age are serious, as more than 70% remain chronic carriers of the virus. These chronic carriers are the principal source of infection for other susceptible people, an d are themselves at high risk of developing other serious diseases, su ch as chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma . Theoretically, therefore, routine infant immunisation supplemented w ith prenatal screening of pregnant women for HBsAg or HBeAg and mass i mmunisation of children is the appropriate strategy for control of hep atitis B in these countries. To prevent primary liver cancer associate d with HBV infection, however, immunisation of adults at high risk wou ld also be prudent. Mandatory vaccination of all neonates is recommend ed in highly endemic areas, together with hepatitis B immune globulin in babies born to HBsAg carrier mothers.