From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Q re: hep B
Date: 26 Jun 1998 21:33:27 GMT

In <6n0tkv$ja5@dfw-ixnews4.ix.netcom.com> . <bandit5@ix.netcom.com>
writes:

>Is it possible to contract hep B from contaminated food? I know this is
>true for hep A; a doc told me it's also true for hep B, but I've not been
>able to find anything verifying this and I'm just curious. Please respond
>via e-mail. Thanks.


   It's very unlikely.  They actually did human trial on this in the
50's and early 60's, with prisoners eating capsules of feces from
people with active hepatitis B (a procedure which is VERY effective at
transmitting hepatitis A).  They didn't get the disease.

   Hep B is transfered by infected serum or semen.  Contaminated food
would have to have blood or perhaps semen in it (unlikely).  And to get
the disease from contaminated food, you'd have to have extensive open
wounds in your mouth or stomach.  The closest you'll find to this is
one person using a toothbrush on bleeding gums, and another person in
the same household using the same toothbrush on bleeding gums (hep B
has been transmitted that way).  For food, it's just not going to
happen.

                                    Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.aids,sci.med
Subject: Re: An HIV Epidemic via the HBV Vaccine?
Date: 21 Feb 1999 17:23:14 GMT

In <HY8gxijHSatM@mcrcr6> holzmr01@mcrcr6.med.nyu.edu (ROBERT S.
HOLZMAN) writes:

>In article <36f6d2a4.256283622@news.primenet.com>, fredshaw@primenet.com
>(fred) writes:
>
>> Billi Goldberg offers the following:
>>
>> Since samples from seven men were shown to be HIV-1 antibody positive
>> in the late 1970s before entering the NYC HBV trial (Stevens et al.,
>> 1985), it is highly probable that HIV-1 antibody positive men were
>> donors for the HBV vaccine.


     Nonsense.   Billi Goldberg seems to be under the impression that
the vaccine was prepared with stuff from pain city plasma donors, as
was clotting factor.  In fact, it was prepared from very small group of
very carefully screened donors working for the drug company, and then
subjected to an unprecedented number of different heat and chemical
sterilization proceduces, each of which which would have killed HIV
many times over.  Something they couldn't do to clotting factor without
it losing activity.


>But the fact that there was no difference in the incidence of aids in
>vaccine and placebo recipients, as was published in the mid 1980s when
>the question first came up, disproves the transmission in the
>hepatitis vaccine.


    Just so.  And hardly a surprise.  When I had my first dose of Hep B
vaccine in 1985, I read the package insert very carefully.  At that
time, they were still using vaccine from a pool which had been
collected many years before, before AIDS broke out, and not from the
population it broke out IN.  And the number of steps they had taken to
kill anything in it would have gotten the toughest virus known, let
alone a wimpy thing like a retrovirus.  I got the vaccine, and haven't
been sorry (had my boosters, too, though at some point I had the choice
between natural and synthetic antigen, and did chose the synthetic).

                                 Steve Harris, M.D.

From: jrfox@no.spam.fastlane.net.no.spam (Jonathan R. Fox)
Newsgroups: sci.med
Subject: Re: [Rubella on the rise in the U.K.]
Date: Tue, 07 Sep 1999 04:36:38 GMT

On Mon, 06 Sep 1999 19:51:59 -0700, Michael Sierchio <kudzu@dnai.com>
wrote:

>And will one of the M.D.s here please explain why an infant should
>have Hep B vaccine, since it's not a childhood disease?  And a friend
>who's a pediatrician has discovered that the entire series given so
>young doesn't often work -- almost half of the children tested at 3
>years do not show antibodies.  The vaccine is extremely successful
>after age 10,  which is probably early enough to confer immunity
>before sex and IV drug use ;-)

There are several reasons that hepatitis B vaccination during infancy
was instituted.

First, although the "usual" risk factors for hepatitis B, which
includes sexual promiscuity and IV drug abuse, are not present in
early childhood, hepatitis B still does occur in children, and most
children with hepatitis B have no risk factors.  Children do receive
blood transfusions too, after all.

Second, immunization rates are much higher in infants than in
adolescents, because they are in much more frequent contact with
health care providers.  Delaying immunization and then later trying to
get older children to come to their doctor for shots would result in
lower immunization rates.  "Never miss an opportunity to immunize."

Next, experience in Taiwan has shown a remarkable decrease in children
who are chronic carriers for hepatitis B after instituting mass
vaccination of infants.  This will translate to much a lower incidence
of hepatocellular carcinoma, which is related to chronic hepatitis B
infection.

On the issue of waning immunity:  I'm not sure where you saw data that
showed no antibodies in half of immunized children after three years.
The Taiwanese studies have shown that even after 10 years boosters are
not needed.  But even then, it's better to having waning immunity that
you can boost than to have none at all.

Currently in the United States, vaccination of newborns against
hepatitis B is on hold until thimerosol, a mercury-containing
preservative, is removed from the vaccines.  Although the mercury
content in the vaccines is no where near what would be considered
toxic even to a newborn infant, it seems prudent to remove anything
that could be remotely dangerous if it's not necessary.  But the
mercury-free vaccines will be back, and we will resume immunization.

--
Jonathan R. Fox, M.D.

From: sbharris@ix.netcom.com (Steve Harris  sbharris@ROMAN9.netcom.com)
Newsgroups: misc.kids.health,sci.med,misc.health.alternative,sci.med.nursing,
	uk.people.health
Subject: Re: Mass vaccination of adults against hepatitis B 'inappropriate'
Date: 4 Dec 2003 14:23:13 -0800
Message-ID: <79cf0a8.0312041423.7f03bc3e@posting.google.com>

pfriley@watt-not.com (PF Riley) wrote in message
news:<3fced5bf.164901743@news.nwlink.com>...

> In the U.S., we have decided that mass immunization against adults is
> not necessary and is unlikely to be helpful. We are trying to immunize
> all infants.


We should be trying to immunize all unimmunized adults, too. In the US
with clean disposable parenterals and a blood supply clean of hep B,
the disease is essentially a sexually transmitted one. We should have
targeted adults 15-30 FIRST, and only THEN gone after adults 30-50,
and younger children.

There's been a lot of stupidity about infectius hepatitis vaccination
recommendations. To use another example with another virus, if the CDC
and various health organizations hadn't been trying to be "cost
effective" we wouldn't have had 600 people getting hep A, even if the
onions were contaminated.

Oh, well, at least hep A is rarely fatal, and never chronic. Can't say
that about hep B. Some fraction of adults who get it are "Typhoid
Mary's" for the virus, spreading it to all sexual partners, just like
AIDS. It's going to talk half a century to fix this problem by mearly
vaccinating all children. What the hell are these people thinking?

SBH

Who got hep A and B shots as soon as he could, and wishes there was
one for hep C.

From: sbharris@ix.netcom.com (Steve Harris  sbharris@ROMAN9.netcom.com)
Newsgroups: misc.kids.health,sci.med,misc.health.alternative,sci.med.nursing,
	uk.people.health
Subject: Re: Mass vaccination of adults against hepatitis B 'inappropriate'
Date: 5 Dec 2003 16:42:55 -0800
Message-ID: <79cf0a8.0312051642.448b7213@posting.google.com>

pfriley@watt-not.com (PF Riley) wrote in message
news:<3fd0173e.11649742@news.nwlink.com>...

> But if the money saved from not immunizing everyone against hepatitis
> A is put to better use and there is still some left over for people
> who actually get the disease, we could still be better off.


Indeed, but the same thing applies to Hep B. If we used all the money
we're using to vaccinate infants who won't be at risk for another 15
years, to go after kids in junior high who are going to hit maximal
risk in 5 years (or less) then we could save an entire cohort of kids
how are going to miss out, just because they don't happen to be
infants right now.


What the hell are these people thinking?
>
> Here's the answer to your question:
>
> http://www.cdc.gov/mmwr/preview/mmwrhtml/00033405.htm
>
> PF



COMMENT:

I read it. The answer is that they weren't thinking very well.

They do admit:

>>In the United States most persons with hepatitis B acquire the
infection as adolescents or adults. Several specific modes of
transmission have been identified, including sexual contact,
especially among homosexual men and persons with multiple heterosexual
partners; parenteral drug use; occupational exposures; household
contact with a person who has an acute infection or with a chronic
carrier; receipt of certain blood products; and hemodialysis. However,
over one-third of patients with acute hepatitis B do not have readily
identifiable risk factors (1,2). <<

But having said that, they don't think it through. The rationale is
that we can't ever wipe it out, if we don't vaccinate everybody. So
let's do the kids because we have them getting vaccinated at regular
doctor's visits already. This is fine, except that 1) it's a program
that will take 50 years and meanwhile the money could be spend better
fighting the fire where it's burning. The document says childhood
vaccination doesn't "preclude" doing that, but indeed it does, if
money spent doing one public health program is money not spent in
another. And 2) the premise is incorrect because you can't wipe it out
even with the program in place. Even if you vaccinate all US kids,
that doesn't mean you can wipe the disease out here, either. There are
emigrants from (say) Mexico. It's just exactly the same problem we
have with hepatitis A.

And now let's ask a really difficult question: Where's the proof that
kids vaccinated at 12 months old, won't require a booster for immunity
at 20 or 30 ANYWAY?  If they do, you lose the entire argument. But no
such evidence exists. We haven't been vaccinating kids that long. The
government is willing to stipulate that kids vaccinated at birth
should be protected "at least 5 years."  But that's all that can be
said, and we need more for a program like this. Up to 60% of young
adults lose the antibody 9 years after vaccination, but nobody knows
what that means. It doesn't necessarily mean they're totally
unprotected, but probably some are. We're in the dark. Vaccinate
newborns and you lose 12 years of time where the vaccine is nearly
useless, and immunity is decaying away. That should make up for a LOT
of the fact that save money doing it.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: misc.kids.pregnancy,misc.health.alternative,sci.med
Subject: Re: AZT and Wacko American MDs - was Re: MDs forcing kids to take 
	poison
Date: 7 Aug 2005 16:16:39 -0700
Message-ID: <1123456599.503290.101100@g49g2000cwa.googlegroups.com>

Todd Gastaldo wrote:
> In one study MDs refused hepatitis B vaccination - even when it was offered
> free of charge:
>
> "...the majority of physicians...failed to be vaccinated even when offered
> the hepatitis B vaccine free of charge." [Clancy CM, Cebul RD, Williams SV.
> Guiding individual decisions: a randomized controlled trial of decision
> analysis. Am J Med, 1988;84(2):283-8]


COMMENT:

That was back when it was made from the blood of pooled donors. But it
had been carefully tested for HIV and put through 3 different rounds of
treatments, each of which was sufficient to kill HIV (not possible to
do for blood factor products, but possible for the vaccine). Finally,
the donor pool for the hep B vaccine protein was a closed one
consisting of carefully chosen HIV-neg chronic hepatitis B patients,
and not the same group of lowlife plasma donors that donated for factor
concentrates, and who were more likely to have HIV (and who ended up
transmitting HIV in factor concentrates in 1982-3). So many a doc made
the opposite decision for hep B. Including me, who had my first Hep B
vaccination shots in 1985.

By the time for my next booster in 1990, I believe a genetically
engineered product had been around, which had never seen human blood.
You could get one or the other, and I don't remember which one I chose.
Since then, the issue you bring up has been a non-issue. The vaccine
from human donors is long off the market.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: misc.kids.pregnancy,misc.health.alternative,sci.med
Subject: Re: AZT and Wacko American MDs - was Re: MDs forcing kids to take 
	poison
Date: 8 Aug 2005 14:59:48 -0700
Message-ID: <1123538388.713412.221560@g43g2000cwa.googlegroups.com>

Todd Gastaldo wrote:

> You snipped the bigger issue: Most African children with evidence of Hep B
> had no Hep B disease - and no (?) evidence that Hep B vaccine prevents
> hepatocellular carcinoma.


COMMENT:

There's lots of evidence the vaccine will prevent some fraction of
hepatocellular carcinoma (HCC), though it's indirect evidence, since
the virus takes 30-40 years or more to do this, and so the study would
need to be a run a very long one. Very occasionally one sees in
children, and the rates of this have declined a great deal in countries
like Taiwan where vaccination was instituted first.

If you know anything about hepadnaviruses in animals and how they are
connected with liver cancer, you'll have little doubt that the
epidemiology in humans vis a vis our own particular hepadnavirus (hep
B) is real.

In any case, the vaccine is of very very little risk (as seen in
controlled studies in China), and there are many many reasons other
than cancer to give it. Such as prevention of acute and chronic
hepatitis B :).  Duh.


> Also, you snipped the part about Hep B vaccinations injected into Third
> World children as American MDs refused the same Hep B vaccinations.


COMMENT:
They weren't done at the same time, you ninny. Please look at your
facts. While hep B was being made from human blood it was WAY too
expensive to be shipping to Africa, I assure you.


> Maybe American MDs ("many a doc") made a public protest that Third World
> children should not be injected with a Hep B vaccine that American MDs
> weren't taking for fear of catching AIDS?
>
> Maybe I just missed it?


COMMENT:

Yeah, you missed it. There was nothing to miss. The two cases didn't
involve the same vaccine.

I personally, BTW, wouldn't give a patient any standard preventive
thing I wasn't willing to take myself. I've had every vaccine you can
name, and some you've never heard of.


> I mention this because - recently - American MDs didn't go public about
> thimerosal going into Third World bloodstreams...
>
> Or maybe they did and I just missed it?


Thimerosol's a political problem. Epidemiologically it's a no-show.

> Robert Kennedy writes:
>
> "Vaccine manufacturers had already begun to phase thimerosal out of
> injections given to American infants -- but...CDC and FDA...[bought] up the
> tainted vaccines for export to developing countries..."
> http://www.commondreams.org/views05/0616-31.htm

COMMENT:

Robert Kennedy's a no-show, too. Sucked into one of the stupider
liberal causes, when the world is full of very genuine problems that
need fixing. Such as how to vaccine the third world cheaply. Here we
have one child die of preventable measles EVERY MINUTE OF EVERY DAY in
Africa, and this moron JFK,Jr is worried that we might be giving them
**autism**? Of the 1.8 million vaccine preventable deaths in the third
world, HALF are measles. Screw the thimerosal. Those kids need MMR and
they need it *yesterday.* And RFK,Jr seems something to keep him busy,
like organized crime.

Say, if he could just get a brother elected president, maybe he could
get to be attorney general....   Meanwhile he's a pretty pathetic
characature of his relatives.

This is where liberalism really bugs me. Liberals are the poison
paranoia people. Somebody finds some kind of politically correct
"poison" like thimerosal, and regardless of the evidence for, or
against, liberals will try to hamstring a program that will save 3/4
million kids a year, to keep it from being used. Unintended
consequences.  They don't care. If the solution doesn't fit their
utopian vision, they'd rather *prevent* a reasonable version of it used
at all.

Disgusting!


SBH



1: Baillieres Best Pract Res Clin Gastroenterol. 1999 Dec;13(4):511-7.

Prospects for hepatitis B virus eradication and control of hepatocellular
carcinoma.

Chang MH, Chen DS.

Department of Pediatrics and Internal Medicine, College of Medicine,
National Taiwan University, Taipei.

Hepatitis B virus infection is the most common cause of chronic
hepatitis, liver cirrhosis and hepatocellular carcinoma worldwide. In
areas hyperendemic for HBV infection, the related complications occur
mostly during adulthood.  However, nearly half of all primary infection
in chronic carriers occurs in the perinatal period through maternal
transmission, the other half arising from horizontal transmission mainly
through intrafamilial spread or injection using unsterilized needles. A
universal vaccination programme is better than immunization for at-risk
groups. Hepatitis B vaccination should be integrated into the Expanded
Programme on Immunization in children. Universal immunization against
hepatitis B virus has proved to be effective in reducing the hepatitis B
carrier rate to one-tenth of the prevalence before the vaccination
programme in highly endemic areas, and the incidence of hepatocellular
carcinoma in children has also been shown to be significantly reduced.
Continued efforts to implement universal vaccination programmes worldwide
will very likely reduce the incidence of hepatitis B virus-related
diseases, particularly liver cirrhosis and hepatocellular carcinoma.

Publication Types:
    Review
    Review, Tutorial

PMID: 10654916 [PubMed - indexed for MEDLINE]

2: JAMA. 2000 Dec 20;284(23):3040-2.

Hepatitis B vaccination and hepatocellular carcinoma rates in boys and
girls.

Chang MH, Shau WY, Chen CJ, Wu TC, Kong MS, Liang DC, Hsu HM, Chen HL,
Hsu HY, Chen DS; Taiwan Childhood Hepatoma Study Group.

Department of Pediatrics, National Taiwan University Hospital, No. 7,
Chung-Shan S. Road, Taipei, Taiwan, Republic of China.
mhchang@ha.mc.ntu.edu.tw

CONTEXT: Hepatocellular carcinoma (HCC) has a male predominance and is
closely related to hepatitis B virus (HBV) infection. Hepatitis B virus
vaccination was launched in 1984 in Taiwan for neonates of mothers
carrying hepatitis B e antigen, resulting in a decreased incidence of HCC
in children. The effect on boys vs girls is not known. OBJECTIVE: To
evaluate the association between a HBV vaccination program with incidence
of childhood HCC by sex. DESIGN AND SETTING:  Analysis of data collected
from Taiwan's National Cancer Registry System and the Taiwan Childhood
Hepatoma Study Group between 1981 and 1996.  PARTICIPANTS:  Children aged
6 to 14 years who were diagnosed as having HCC (201 boys and 70 girls).
MAIN OUTCOME MEASURE: Incidence of HCC in boys and girls before and after
implementation of the vaccination program. RESULTS: The boy-girl
incidence ratio decreased steadily from 4.5 in 1981-1984 (before the
program's introduction) to 1.9 in 1990-1996 (6-12 years after the
vaccination program was launched). The incidence of HCC in boys born
after 1984 was significantly reduced in comparison with those born before
1978 (relative risk [RR], 0.72; P =.002). No significant decrease in HCC
incidence was observed in girls born in the same periods (RR, 0.77; P
=.20). The incidence of HCC in boys remained stable with increasing age,
while an increase of HCC incidence with age in girls was observed. These
age and sex effects remained the same regardless of birth before or after
the vaccination program. CONCLUSION: Our results suggest that boys may
benefit more from HBV vaccination than girls in the prevention of HCC.

PMID: 11122592 [PubMed - indexed for MEDLINE]

3: Cancer J. 2004 Mar-Apr;10(2):67-73.

Hepatocellular carcinoma: paradigm of preventive oncology.

O'Brien TR, Kirk G, Zhang M.

Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics,
National Cancer Institute, National Institutes of Health, Department of
Health and Human Services, Rockville, Maryland 20852, USA.
obrient@exchange.nih.gov

Morbidity and mortality from hepatocellular carcinoma (HCC), which is
primarily caused by hepatitis B virus or hepatitis C virus, can be
prevented.  Public health interventions have eliminated transfusion
transmission of these viruses and, in endemic countries with effective
hepatitis B virus vaccination programs, have greatly reduced incident
hepatitis B virus infections (and HCC) in children. Antiviral treatment
can eliminate detectable hepatitis C virus in 50%-80% of chronically
infected patients, presumably reducing their risk of cancer. HCC survival
rates remain universally poor, but early detection and treatment in
developed countries has improved survival in selected patients.  Despite
these advances, worldwide HCC rates remain high, and additional
preventive efforts are needed. The most important opportunity is wider
distribution of hepatitis B virus vaccine in endemic areas. Development
of an HCV vaccine, improved antiviral therapies, and better methods for
HCC detection would also help decrease morbidity and mortality from HCC.
HCC prevention efforts provide a paradigm for preventive oncology in
cancers of viral etiology.

Publication Types:
    Review
    Review, Tutorial

PMID: 15130266 [PubMed - indexed for MEDLINE]

4: Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1998
Nov-Dec;39(6):366-70.

Hepatocellular carcinoma in children.

Chang MH.

Department of Pediatrics, National Taiwan University Hospital, Taipei,
Taiwan.  mhchang@ha.mc.ntu.edu.tw

Hepatocellular carcinoma (HCC) is one of the most frequent malignancies
in humans. Although it occurs mainly in adults of 40 to 60 years of age,
it may develop in children. It mainly occurs in children older than six
years of age, with male predominance. Children with chronic hepatitis B
virus (HBV) infection and underlying metabolic diseases are the two main
high risk groups for childhood HCC. HBV infection is the main cause of
childhood HCC in areas hyperendemic for HBV infection. In Taiwan, nearly
100% of HCC children were hepatitis B surface antigen seropositive.
Maternal transmission (94%) is the most important route of transmission
of HBV infection in HCC children.  For HBV related HCC in children,
immunization is the most effective way for the control of childhood HCC.
The first universal vaccination against HBV in the world was launched in
Taiwan in July 1984. The prevalence of hepatitis B surface antigenemia in
children declined from 10% in 1984, prior to the vaccination program, to
< 1% in 1994, 10 years after the implementation of the program, in
children less than 9 years of age. The annual incidence of HCC in
children aged 6 to 9 years of age also decreased from 0.52 per 100,000
born in 1974-1984 to 0.13 per 100,000 born in 1984-1986.

Publication Types:
    Review
    Review, Tutorial

PMID: 9926508 [PubMed - indexed for MEDLINE]

5: N Engl J Med. 1997 Jun 26;336(26):1855-9.

Comment in:
    N Engl J Med. 1997 Jun 26;336(26):1906-7.

Universal hepatitis B vaccination in Taiwan and the incidence of
hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study
Group.

Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, Liang DC, Shau WY,
Chen DS.

Department of Pediatrics, National Taiwan University Hospital, Taipei.

BACKGROUND: A nationwide hepatitis B vaccination program was implemented
in Taiwan in July 1984. To assess the effect of the program on the
development of hepatocellular carcinoma, we studied the incidence of this
cancer in children in Taiwan from 1981 to 1994. METHODS: We collected
data on liver cancer in children from Taiwan's National Cancer Registry,
which receives reports from each of the country's 142 hospitals with more
than 50 beds. Data on childhood liver cancer were also obtained from
Taiwan's 17 major medical centers. To prevent the inclusion of cases of
hepatoblastoma, the primary analysis was confined to liver cancers in
children six years of age or older. Data were also obtained on mortality
from liver cancer among children. RESULTS: The average annual incidence
of hepatocellular carcinoma in children 6 to 14 years of age declined
from 0.70 per 100,000 children between 1981 and 1986 to 0.57 between 1986
and 1990, and to 0.36 between 1990 and 1994 (P<0.01). The corresponding
rates of mortality from hepatocellular carcinoma also decreased. The
incidence of hepatocellular carcinoma in children 6 to 9 years of age
declined from 0.52 for those born between 1974 and 1984 to 0.13 for those
born between 1984 and 1986 (P<0.001). CONCLUSIONS: Since the institution
of Taiwan's program of universal hepatitis B vaccination, the incidence
of hepatocellular carcinoma in children has declined.

PMID: 9197213 [PubMed - indexed for MEDLINE]

6: Semin Oncol. 2001 Oct;28(5):441-9.

The epidemiology and prevention of hepatocellular carcinoma.

Monto A, Wright TL.

GI Research, San Francisco Veterans Affairs Medical Center, San
Francisco, CA 94121, USA.

Hepatocellular carcinoma (HCC) is a common cancer. Its incidence is
higher in countries where hepatitis B is endemic. HCC is substantially a
complication of liver cirrhosis. Hepatitis B virus (HBV) and hepatitis C
virus (HCV) are the predominant causes of cirrhosis, and as such, HCC.
The link between HCC and alcoholic cirrhosis is less strong. Other less
common forms of chronic liver disease can also lead to HCC. HBV is the
HCC-determining disease worldwide. In endemic regions, it tends to be
acquired early in life. The largest strides in prevention of HCC have
been made with the HBV vaccine. HCV has a lower global prevalence than
HBV, but HCV causes the most HCC in economically developed regions. In
these areas, where the incidence of HCC is low, HCV now accounts for more
than 50% of HCCs. There is no vaccine for HCV, so prevention of
HCV-associated HCC will focus on prevention of initial infection and
elimination of infection through antiviral therapies. HBV-HCV
coinfection, and the combination of either with alcohol abuse or
aflatoxin exposure seems to raise the risk of HCC development further.
Liver transplantation and other adjuvant therapies may offer better
options for secondary prevention of HCC than resection alone. Copyright
2001 by W.B. Saunders Company.

Publication Types:
    Review
    Review, Tutorial

PMID: 11685737 [PubMed - indexed for MEDLINE]

7: Cancer Detect Prev. 1991;15(4):313-8.

Design and compliance of HBV vaccination trial on newborns to prevent
hepatocellular carcinoma and 5-year results of its pilot study.

Sun Z, Zhu Y, Stjernsward J, Hilleman M, Collins R, Zhen Y, Hsia CC, Lu
J, Huang F, Ni Z, et al.

Cancer Institute, Chinese Academy of Medical Science, Beijing, PRC.

A large-scale, controlled study of universal immunization of newborns
against HBV infection has been conducted in the high incidence area of
hepatocellular carcinoma, Qidong County of China. This area has a stable
population, standardized cancer registration system, and an
epidemiological base for measurements of liver cancer prevention by
vaccine. Randomization was done on the community level. The vaccination
and the control group each will consist of 38,000 children by the end of
1990. It is anticipated that the design will provide high statistical
power to detect 50% reduction in the prevalence rate of chronic hepatitis
among the vaccinees vs. the controls at 6 to 10 years of age, and 50%
reduction in the incidence rate of hepatocellular carcinoma at 35 to 40
years of age. The vaccine used is Hep-B Vax, donated by Merck and Co.
through WHO. The vaccine was administered at 0, 1, and 6 months after
birth, the dosage of 5 or 2.5 micrograms in the pilot study as used
before 1985 and of 5 micrograms dose level during the main study starting
from January 1, 1985. About 85% of the cohorts have now entered the
protocol. The vaccination coverage during 1984 to 1989 was 98.0%
(35,064/35,789). Follow-up of the vaccinees and the age-matched controls
at 5 years has exceeded 97%. The cumulative mortality in the vaccinated
group up to 1988 was 1.29% (354/27,450). No single death nor serious
adverse reaction was found that was associated with vaccination. The use
of HBV vaccine at a reduced dose was especially important for the
developing countries at the present time in order to achieve widespread
immunization.  Five-year results of the pilot study of this vaccination
project showed that significant protection against HBV infection was
achieved with the 5 or 2.5 micrograms per dose regimen plus a booster of
5 micrograms given at 3.5 to 4 years of age.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types:
    Clinical Trial
    Randomized Controlled Trial

PMID: 1665400 [PubMed - indexed for MEDLINE]