The impact of national viral hepatitis therapy program and hepatitis B vaccination program on mortality from acute and chronic viral hepatitis in Taiwan

摘要

BackgroundIn Taiwan, the national hepatitis B virus vaccination program and national viral hepatitis therapy program were implemented to control the infections of hepatitis viruses and their progressive illnesses. Studies have evaluated the impacts of two national health programs on many liver-related diseases, but not on acute and chronic viral hepatitis. The purpose of this study was to evaluate the impact on the mortality of acute and chronic viral hepatitis.MethodsPoisson regression models were used to estimate the adjusted rate ratios of the different period groups and corresponding 95% confidence intervals for childhood, adulthood and elderhood, and to estimate the adjusted rate ratios of vaccinated cohorts and corresponding 95% confidence intervals.ResultsCompared with period of 2000-2003, the adjusted rate ratios for period groups of 2008-2011 and 2012-2015 reported a significantly increasing risk of acute and chronic viral hepatitis mortality, except for the childhood and female adulthood. For population without vaccination, the adjusted rate ratios of acute and chronic viral hepatitis B mortality were 0.99 (95% CIs 0.88-1.12), 1.30 (95% CIs 1.17-1.45) and 1.42 (95% CIs 1.28-1.55) for periods of 2004-2007, 2008-2011 and 2012-2015, respectively, comparing with unimplemented period of national viral hepatitis therapy program. Compared with 1967-1983 cohorts, the adjusted rate ratio of 1984-2000 cohorts was 0.46 (95% CIs 0.28-0.75), and the adjusted rate ratios were 0.49 (95% CIs 0.28-0.87) and 0.35 (95% CIs 0.11-1.05) for male and female, respectively.ConclusionThis study revealed the significantly higher mortality rates of acute and chronic viral hepatitis during the implemented period of national viral hepatitis therapy program, comparing the unimplemented period. Such ineffectiveness may be attributable to the low coverage rate. The national vaccination program was currently an effective strategy for controlling the mortality of viral hepatitis.