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Hepatitis B in China

2007; Elsevier BV; Volume: 369; Issue: 9573 Linguagem: Inglês

10.1016/s0140-6736(07)60723-5

1474-547X

Jie Liu, Daiming Fan,

Liver Disease Diagnosis and Treatment

Roughly 400 million people are infected with HBV worldwide. 1 Lai CL Ratziu V Yuen MF Poynard T Viral hepatitis B. Lancet. 2003; 362: 2089-2094 Summary Full Text Full Text PDF PubMed Scopus (724) Google Scholar The disease is endemic in China, where a national survey in 2002 showed a 9% rate of HBsAg in the general population. 2 Liang XF Chen YS Wang XJ et al. A study on the sero-epidemiology of hepatitis B in Chinese population aged over 3-years old: the report from Chinese Center for Disease Control and Prevention. Chin J Epidemiol. 2005; 26: 655-658 Google Scholar Around 120 million people in China are carriers of HBV (almost a third of the people infected with HBV worldwide); 30 million people in the country are chronically infected. 3 Liu GT Si CW Wang QH et al. Comments on the prevention and research of chronic hepatitis in China. Natl Med J China. 2002; 82: 74-76 Google Scholar During a 5-year period, 10–20% of patients with chronic hepatitis developed cirrhosis, and 20–23% of the cases with compensated cirrhosis progressed to decompensated cirrhosis. 6–15% of the people with cirrhosis and chronic hepatitis progressed to hepatocellular carcinoma (HCC). 5-year survival for compensated cirrhosis is 55%, that for decompensated cirrhosis is 14%, and that for HCC is less than 5%. 4 Si CW Current status and problem of chronic hepatitis B. Clin Med J. 2006; 4: 1-2 Google Scholar Every year, 300 000 people die from HBV-related diseases in China, including 180 000 patients with HCC. 5 Jia JD Zhuang H The overview of the seminar on chronic hepatitis B. Chin J Hepatol. 2004; 12: 698-699 PubMed Google Scholar However, the incidence of hepatitis B is still increasing, from 21·9 in 100 000 people in 1990 to 53·3 in 100 000 in 2003. 6 Wang XJ Zhang RZ Hu YS Liang XF Analysis on epidemic status of viral hepatitis in China: the report from Chinese Center for Disease Control and Prevention. Dis Surveillance. 2004; 19: 290-292 Google Scholar That increase has occurred despite a vaccination programme for newborn babies since the 1990s, which showed good effectiveness for reducing chronic HBV infection in children. 7 Cui FQ Wang XJ Liang XF Epidemiological analysis on reported hepatitis B under 15 years in China: the report from Chinese Center for Disease Control and Prevention. Chin J Vaccines Immunization. 2006; 12: 206-208 Google Scholar The reason for this increased HBV infection is unknown, because hepatitis B has no clear transmission routes in many people in China, although both neonatal infection and horizontal transmission during early childhood are still the most common routes.