[Vaccination against hepatitis B virus: current data]

Infection by hepatitis B virus remains a major health problem in the world despite the availability of effective vaccines. Although vaccination programs targeting high risk groups have been pushed to their limits, high prevalence rates persist especially in endemic zones. More recently mass vaccination programs conducted on Taiwan have demonstrated the efficacy of this approach with a decrease in the number of chronic hepatitis B virus carriers in the general population in association with a decrease in the incidence of hepatocellular carcinoma, one of the most serious complications of chronic hepatitis B virus infection. Side effects have been reported including the risk of central nervous system demyelination. However studies have shown no evidence of a significant correlation between vaccination and this type of disease. Occurrence of hepatitis B in properly vaccinated subjects could result from selection of mutant viral strains able to escape detection by the immune system. The recently revised benefit-to-risk ratio remains highly favorable for vaccination. Current data indicates that the policy of mass vaccination of the population should be pursued.