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REVIEW ARTICLE
Year : 2005  |  Volume : 2  |  Issue : 1  |  Page : 31-55

Preventive and therapeutic approaches against hepatitis B virus by vaccine


Third Department of Internal Medicine, Ehime University School of Medicine, Toon city, Ehime 791-0295, Japan

Correspondence Address:
Morikazu Onji
Third Department of Internal Medicine, Ehime University School of Medicine, TO ON city, Ehime 791-0295
Japan
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Source of Support: None, Conflict of Interest: None


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Hepatitis B virus (HBV) infection is caused by a small enveloped DNA virus that infects the liver. Approximately 2 billion people of the world have been infected by HBV and 300-350 million of them are chronically infected with the virus. The annual global mortality rate from HBV infection and its sequelae is 1-2 million people. Control of HBV infection is a major challenge of contemporary virology, hepatology, immunology, and vaccinology. There are two important aspects of this problem. The first is the prevention of new HBV infection. Transmission of HBV from HBV-infected persons to uninfected healthy individuals can be blocked by interrupting the transmission cycle of the virus. But, this is extremely hard and time-consuming, especially in view of the socio-economic status and health care delivery system of most of the developing nations, where HBV carrier rate is high. Another practical solution to this problem is by immunoprophylaxis using vaccines against hepatitis B. Commercially available hepatitis B vaccines induce protective antibody against HBV in more than 90% of apparently healthy individuals. However, these vaccines are ineffective in about 5-10% of normal individuals, most immunosuppressed subjects and also in liver transplanted patients with HBV background. Accordingly, a more potent prophylactic vaccine against HBV is needed. The concept of using vaccine for treatment of chronic diseases (vaccine therapy) has existed for quite a long time, but very few clinical trials with vaccine therapy have been conducted to assess their efficacy and clinical usage. During the last decade, some studies have reported the use of hepatitis B vaccine to treat patients with chronic hepatitis B. The present regimen of vaccine therapy for patients with chronic hepatitis B is safe, but is not very effective as an independent therapeutic tool. This article reviews the development of more potent prophylactic vaccines against HBV and better regimens of therapeutic vaccines for patients with chronic hepatitis B with special reference to the recent developments in the relevant fields.


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