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Qu et al. Hepatoma Res 2017;3:228-40 Hepatoma Research
DOI: 10.20517/2394-5079.2017.41
www.hrjournal.net
Review Open Access

Reducing liver cancer risk beginning at

birth: experiences of preventing chronic

hepatitis B virus infection in China

Chunfeng Qu , Zhongping Duan , Kun Chen , Huaibin Zou 3
1
3
1,2
1 Department of Immunology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
100021, China.
2 State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing 100021, China.
3 Artificial Liver Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China.
Correspondence to: Dr. Chunfeng Qu, Department of Immunology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing 100021, China. E-mail: quchf@cicams.ac.cn; Dr. Zhongping Duan, Artificial Liver Center, Beijing YouAn
Hospital, Capital Medical University, Beijing 100069, China. E-mail:duan2517@163.com

How to cite this article: Qu C, Duan Z, Chen K, Zou H. Reducing liver cancer risk beginning at birth: experiences of preventing chronic hepatitis B
virus infection in China. Hepatoma Res 2017;3:228-40.

ABSTRACT

Article history: In China, the death numbers due to primary liver cancer every year account for more than half of
Received: 4 Sep 2017 this disease burden worldwide. Hepatocellular carcinoma (HCC) represents the major histological
Accepted: 18 Oct 2017 type of primary liver cancer. In the Chinese population, at least 85% HCC cases are due to chronic
infection with hepatitis B virus (HBV), most of which were acquired in the perinatal period or in
Published: 25 Oct 2017
early life. As of January 1992, HBV immunization of newborns was introduced to the national
Key words: Expended Program of Immunization of China. Prior to this program, the Qidong County in China
Hepatocellular carcinoma, conducted an hepatitis B intervention study, which was a population-based, cluster randomized,
prevention, controlled trial of HBV vaccination in neonates. The study demonstrated that among young
vaccination, adults < 30 years old, neonatal HBV immunization decreased around 84% risk of HBV-related
antiviral therapy, liver cancer, and 70% risk of mortality due to severe end-stage chronic liver diseases. More than
adolescent vaccine boost 72% efficacy of neonatal vaccination against chronic HBV infection in adulthood was achieved;
however, when catch-up HBV vaccination was given to children at age 10-14 years, the protection
efficacy was only 21%. No difference in mortality of HBV-related liver diseases was observed
among the young adults < 30 years who received and those who did not receive the catch-up HBV
vaccination. These results highlight the crucial importance of HBV vaccination of neonates in
reducing the liver cancer risk beginning at birth in highly HBV endemic regions. Due to large
numbers of HBV-infected pregnant women with high viremia in China, clinical studies in which
antiviral therapy with the nucleot(s)ide analogues was given to HBV-infected pregnant women
have provided important evidence that such therapy can reduce the risk of mother-to-child HBV
transmission. These clinical data based on cohort studies, randomized clinical trials, and clinical
practices in the Chinese population provide important information on prevention of liver cancer,
particularly HCC, by preventing chronic HBV infection starting from birth for other populations.

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