Hepatitis B virus infection among pregnant women in Taiwan: Comparison between women born in Taiwan and other southeast countries

Ching-Chiang Lin¹^,2^,3 , Hsiu-Shu Hsieh⁴ , Yu-Jie Huang⁵ , Yeou-Lih Huang³^,6 , Ming-Kun Ku⁷ and Hsin-Chia Hung⁸^,9

¹Department of Laboratory Medicine, Fooyin University Hospital, Pingtong, Taiwan

²Basic Medical Science Education Center, Fooyin University, Kaohsiung, Taiwan

³Graduate Institute of medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

⁴Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan

⁵Department of Radiation Oncology, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University College of Medicine; Kaohsiung, Taiwan

⁶Faculty of Biomedical Laboratory Science, Kaohsiung Medical University, Kaohsiung, Taiwan

⁷Department of Internal Medicine Fooyin University Hospital, Pingtong, Taiwan

⁸Graduate Institute of Health Care, MeiHo Institute of Technology, Pingtong, Taiwan

⁹Global Center of Excellence for Oral Health Research and Development, Kaohsiung Medical University, Kaohsiung, Taiwan

author email corresponding author email

BMC Public Health 2008, 8:49doi:10.1186/1471-2458-8-49


Published:	7 February 2008

Abstract

Background

Taiwan's national vaccination program has successfully decreased the prevalence of hepatitis B infection after twenty years of implementation and might be indirectly beneficial to the second generation. In this study, we compared the hepatitis B infection status of two groups: pregnant Taiwanese women and other Southeast Asian women, who because they had immigrated later in life to Taiwan by marriage to a Taiwanese man, had not been exposed to that vaccination program to evaluate the effect of hepatitis vaccination program on women of child-bearing age and further explored the potential impact of immigration on the hepatitis B public health policy in Taiwan.

Methods

Data was collected from 10,327 women born in Taiwan and 1,418 women born in other Southeast Asian countries, both groups receiving prenatal examinations at Fooyin University Hospital between 1996 and 2005. The results of serum hepatitis B s-Antigen (HBsAg) and hepatitis B e-Antigen (HBeAg) tests and other demographic data were obtained by medical chart review.

Results

The pregnant women from Taiwan had a higher HBsAg positive rate (15.5%) but lower HBeAg(+)/HBsAg(+) ratio (32.1%) than the women from other countries (8.9% and 52.4%). For those born before July, 1984, the period of no national vaccination program, Taiwanese women had a higher HBsAg positive rate than other Southeast Asian women (15.7% vs. 8.4%), but for women born after that day and before June 1986, the period of vaccination for high risk newborns, the HBsAg positive rates found to be slightly lower for Taiwanese women than for other Southeast Asian women (11.4% vs. 12.3%) and the difference was more significant (3.1% vs. 28.6%) after June 1986, the period of vaccination for all newborns. While the HBeAg(+)/HBsAg(+) ratios decreased with age in both groups, they were consistently higher in women from other Southeast Asian countries than in women born in Taiwan after age 20.

Conclusion

In Taiwan, the neonatal vaccination program that was implemented in 1984 has successfully reduced hepatitis B infection among pregnant women in present day, and is likely to indirectly prevent hepatitis B infection in the next generation. However, the increasing number of pregnant women from other Southeast Asian countries without a national neonatal vaccination program or with a program that was introduced later than the one in Taiwan will likely lessen the positive impact of this program and should be further assessed.