公开发布：30月 - 2014年新生儿乙肝疫苗降低肝癌风险

StephenW

Public Release: 30-Dec-2014 Neonatal HBV vaccine reduces liver cancer risk

PLOS

Neonatal HBV vaccination reduces the risk of liver cancer and other liver diseases in young adults in China, according to a study published by Chunfeng Qu, Taoyang Chen, Yawei Zhang and colleagues from the Cancer Institute & Hospital at the Chinese Academy of Medical Sciences, Qidong Liver Cancer Institute, China, and Yale School of Public Health and School of Medicine, USA in this week's PLOS Medicine.

The researchers report long-term outcomes from the Qidong Hepatitis B intervention Study (QHBIS), a randomized controlled trial of neonatal HBV vaccination that was conducted between 1983 and 1990 in Qidong County, a rural area in China with a high incidence of HBV-related primary liver cancer (PLC) and other liver diseases. In this study, 41 rural towns (including a total of 77,658 newborns over the study period) were randomized to the intervention (HBV vaccination for all newborns) or control (no vaccination) groups, with two-thirds of the control group participants receiving a catch-up vaccination at age 10-14 years.

By collecting data on new cases of liver diseases over 30 years from a population-based tumor registry, the researchers estimated that the protective efficacy of vaccination was 84% for primary liver cancer (vaccination reduced the incidence of liver cancer by 84%), 70% for death from liver diseases, and 69% for the incidence of infant fulminant hepatitis. Based on survey data collected in 1996-2000 and 2008-2012 on HBsAg seroprevalence, an indicator of current hepatitis B virus (HBV) infection, they conclude that the efficacy of the catch-up vaccination on HBsAg seroprevalence in early adulthood was weak compared to neonatal vaccination (21% versus 72%). While these findings support the importance of neonatal HBV vaccination, the small number of cases of primary liver cancer and other liver diseases observed during the 30-year follow up, the length of follow-up, and the availability of incomplete data on seroprevalence all limit the accuracy of these findings.

The authors say: "Neonatal HBV vaccination significantly decreased HBsAg seroprevalence in childhood through young adulthood and subsequently reduced the risk of PLC and other liver diseases in young adults." They continue: "Our results also suggest that an adolescence booster should be considered in people who were born to HBsAg-positive mothers and completed HBV neonatal vaccination series."

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Research Article

Funding: The current project was support by the State Key Projects Specialized on Infection Diseases (2012ZX10002008), 973 Program Project of China 2013CB910303, and the National Institutes of Health grant HD70324. It was also funded previously by the 6th to 11th key Technologies R&D program of China. The Merck Co. donated the vaccine and conducted the quality control tests. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Qu C, Chen T, Fan C, Zhan Q, Wang Y, et al. (2014) Efficacy of Neonatal HBV Vaccination on Liver Cancer and Other Liver Diseases over 30-Year Followup of the Qidong Hepatitis B Intervention Study: A Cluster Randomized Controlled Trial. PLoS Med 11(12): e1001774.doi:10.1371/journal.pmed.1001774

Author Affiliations:

Chinese Academy of Medical Sciences & Peking Union Medical College, CHINA

Qidong Liver Cancer Institute, CHINA

National Office for Cancer Prevention and Control, Chinese Academy of Medical Sciences, CHINA

Yale School of Public Health, Yale University School of Medicine, UNITED STATES

Contact:

Chunfeng Qu
State Key Lab of Molecular Oncology, Cancer Institute/Hospital
Chinese Academy of Medical Sciences & Peking Union Medical College
China
+86 (10) 8778 3103
[email protected]

Yawei Zhang
School of Public Health
Yale School of Medicine
UNITED STATES
+1 (203) 785 6210
[email protected]

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StephenW

公开发布：30月 - 2014年新生儿乙肝疫苗降低肝癌风险

PLOS

新生儿乙肝疫苗接种降低肝癌和青壮年在中国其他肝脏疾病的风险，根据在中国医学科学院，启东发表春风曲，陶阳晨，王亚伟张和他的同事从癌症研究所和医院的一项研究肝癌研究所，中国和公共卫生耶鲁大学和医学院，美国在本周的PLoS医学学院。

研究人员报告说，从启东乙肝干预研究（QHBIS），新生儿乙肝疫苗接种的随机对照试验，在祁东县，农村地区在中国与HBV相关的高发病率1983年至1990年间进行的长期结果原发性肝癌（PLC）与其他肝病。在这项研究中，41乡镇（共包括77658新生儿在研究期间）被随机分配到干预（乙肝疫苗的所有新生儿）或控制（没有接种疫苗）组，三分之二接收对照组参与者追赶疫苗接种年龄10-14岁。

通过收集关于在从基于人口的肿瘤注册表30年肝脏疾病的新病例数据，研究人员估计，接种的保护效力为原发性肝癌的84％（接种了84％降低肝癌的发病率），70 ％的死亡从肝脏疾病，并为婴儿暴发性肝炎的发生率69％。根据收集的1996-2000年和2008-2012年对HBsAg血清阳性率，目前的乙肝病毒（HBV）感染的指标的调查数据，他们得出结论，在成年早期对HBsAg血清阳性追赶疫苗的疗效较弱相比，新生儿接种（21％对72％）。虽然这些发现支持了新生儿乙肝疫苗接种的重要性，少数原发性肝癌，并在30年观察到的其他肝脏疾病的病例随访，随访的长度和不完整的数据，对所有血清阳性率限制的可用性这些研究结果的准确性。

作者说：“新生儿乙肝疫苗接种显著儿童通过青年期减少乙肝表面抗原血清阳性率和随后减少PLC和青壮年其他肝脏疾病的风险。”他们继续：“我们的研究结果还表明，一个青春期的助推器应该谁出生于HBsAg阳性母亲并完成乙肝疫苗接种的新生儿系列的人可以考虑。”

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研究论文

资金来源：目前的计划是支持国家重点工程专业的感染性疾病（2012ZX10002008），中国2013CB910303973计划项目，以及美国国立卫生研究院授予HD70324。另据此前的6日至11日的关键技术研发中国的D程序资助。在Merck公司捐赠的疫苗，并进行质量控制测试。这项研究的发起人曾在研究设计，数据收集，数据分析，数据解释，或写的稿子没有任何作用。

竞争利益：作者声明：保证不存在利益竞争。

引文：曲C，陈T，范C，詹Q，王Y，等。新生儿乙肝疫苗接种的（2014年）功效上肝癌等肝脏疾病超过30年的随访启东乙肝干预研究：一个整群随机对照试验。公共科学图书馆·医学11（12）：e1001774.doi：10.1371/ journal.pmed.1001774

作者所属机构：

中国医学科学院中国协和医科大学，中国

启东肝癌研究所，中国

用于癌症预防与控制，中国医学科学院，中国国家局

耶鲁大学公共卫生学院，耶鲁大学医学院，美国

联系方式：

春风曲
分子肿瘤学，肿瘤研究所/医院国家重点实验室
中国医学科学院中国协和医科大学
中国
+86（10）87783103
[email protected]

王亚伟张
公共卫生学院
耶鲁大学医学院
UNITED STATES
+1（203）7856210
[email protected]

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