Strategies to control hepatitis B: Public policy, epidemiology, vaccine and drugs.
A nation-wide prevention program utilizing passive-active immunoprophylaxis for high-risk babies against maternal HBV transmission was introduced in Japan in January of 1986. The prevention program was expected to eradicate HBV-related hepatocellular carcinoma (HCC). The aim of this study was to evaluate the effect of this selective prevention program against maternal HBV transmission on the occurrence of HBV-related HCC. We reviewed the annual reports from a nation-wide survey of childhood solid tumors that was reported in the Journal of the Japanese Society of Pediatric Surgeons during the 28 years period from 1981 to 2008. The number of HCC cases were grouped for every 5-year period with an additional period of the past 3 years and compared with those of hepatoblastoma. The reported number of children with hepatoblastoma in each period was constant during the 28 years study period. In contrast, both the number of patients with HBV-related HCC and the ratio of HBV-related HCC to hepatoblastoma gradually decreased over the study period, with a significant drop in the last two periods ranging from 2001 to 2008 (p < 0.001). The prevention program against maternal HBV infection of infants born to HBV carrier mothers may have decreased the occurrence of HBV-related HCC in childhood.