Protection provided by hepatitis B vaccine in a Yupik Eskimo population

Article Abstract:

Hepatitis B is an inflammatory condition affecting the liver that is caused by hepatitis B virus (HBV), which is transmitted mainly by blood and blood products. Protection against this chronic, sometimes fatal disease can often be afforded by immunization with a vaccine specific for HBV. To determine the efficacy and duration of protection that HBV immunization might confer on a large group of Yupik Eskimos (an Eskimo population with a high endemic HBV infection rate), a study was carried out in which 1,581 susceptible persons were immunized with the manufacturer-recommended three-dose regimen. Blood levels of HBV antibodies (molecules produced by the immune system to combat potential HBV infection) were measured annually for seven years. Antibody levels dropped off moderately for the first two years after immunization and were fairly constant for the remaining five years. An arbitrary standard was suggested as a first approximation of adequate HBV antibody levels for the purpose of indicating protection from HBV infection (10 milli-International Units per milliliter of blood); between 52 and 87 percent of the immunized subjects maintained these levels for the seven-year period, depending on age (older subjects showed a more rapid decline than younger). During the seven years following the first dose of vaccine, five responders (subjects who showed an increase in HBV antibody level) and three other persons showed blood changes suggestive of infection with HBV. No subjects developed overt symptoms of HBV, or showed evidence of HBV in the blood when tested by direct measurement. Hence, HBV immunization confers significant protection against infection by HBV. These results suggest that boosting the initial inoculation is not necessary for at least seven years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Physiological aspects, Hepatitis B vaccine, Hepatitis B vaccines, Yupiks

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Hepatitis B-related sequelae: prospective study in 1400 hepatitis B surface antigen-positive Alaska native carriers

Article Abstract:

Individuals who chronically carry the hepatitis B virus, as indicated by the presence of hepatitis B surface antigen, are at increased risk for liver cancer, cirrhosis, and active hepatitis. The mechanisms by which the virus produces active disease are uncertain. Attempts to identify individuals carrying hepatitis B virus revealed that there is a high prevalence of hepatitis B surface antigen among some subgroups of native Americans in Alaska. These natives, who may be Eskimos, Indians, or Aleuts, were screened for conditions related to hepatitis B infection. A total of 1,400 individuals were followed for a total of 7,815 carrier-years. Twenty cases of hepatocellular carcinoma, a liver cancer, 14 cases of active hepatitis, and eight cases of cirrhosis were identified and confirmed by biopsy. These results translate into an annual incidence for hepatocellular carcinoma of 387 per 100,000 men and 63 per 100,000 women; the incidence of active hepatitis was 193 per 100,000 men and 158 per 100,000 women; and the incidence of cirrhosis was 107 per 100,000 men and 95 per 100,000 women. During the study period, 60 individuals died; thirteen of these deaths were due to liver cancer. This makes liver cancer the leading cause of death of those positive for hepatitis B surface antigen. This contrasts with the rest of the Alaskan native population, for whom accidents are the leading cause of death. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Alaska, Liver cirrhosis, Chronic active hepatitis

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A program to control an outbreak of hepatitis A in Alaska by using an inactivated hepatitis A vaccine

Article Abstract:

Vaccinating susceptible persons against hepatitis A appears to effectively halt an epidemic outbreak of hepatitis A. Researchers vaccinated 4,930 susceptible persons in a region of rural Alaska that had experienced 529 cases of hepatitis A in the previous year. In areas where 80% of susceptible persons were vaccinated, the epidemic ceased within four to eight weeks whereas it continued for another 50 weeks in a city where only half of susceptible persons were vaccinated. Over 90% of those vaccinated developed hepatitis A antibody within a month after vaccination.

Usage, Hepatitis A, Viral vaccines

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