Editorial: The next step in controlling HBV in China

British Medical Journal
27 July 2013 (Vol 347, Issue 7918)

The next step in controlling HBV in China
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f4503 (Published 16 July 2013)
Yuanyong Xu, associate professor1, Huihui Liu, research assistant2, Yong Wang, associate professor1, Rongzhang Hao, research assistant1, Zhenjun Li, associate professor3, Hongbin Song, professor1

Focus on preventing perinatal transmission of the virus
Infection with hepatitis B virus (HBV) is one of the most important infectious diseases in China.1 Although highly effective vaccines against HBV have been available since 1982, about 93 million people in China carry the virus, and treatment costs about ¥100bn (£10.6bn; €12.3bn; $16bn) a year.2 As well as being at increased risk of developing cirrhosis and hepatocellular carcinoma,3 carriers often encounter discrimination at school, at work, in relationships, and with families.4

The Chinese government introduced infant vaccination with HPV vaccine in 1992, followed by a national expanded programme for immunisation in 1999, with special efforts to provide a timely dose at birth. Since 2002, the government has paid for the vaccine. Furthermore, from 2009 to 2011, the government provided the vaccine free of charge to all children under 15 who had not been vaccinated.

These measures have helped control the transmission of HBV in China, and the proportion of carriers in the population has dropped from 9.8% to 7.2% between 1992 and 2006. Over the …