Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2015; 21(23): 7074-7083
Published online Jun 21, 2015. doi: 10.3748/wjg.v21.i23.7074
Unsolved problems and future perspectives of hepatitis B virus vaccination
Kazuto Tajiri, Yukihiro Shimizu
Kazuto Tajiri, Department of Gastroenterology, Toyama University Hospital, Toyama 930-0194, Japan
Yukihiro Shimizu, Gastroenterology Center, Nanto Municipal Hospital, Toyama 932-0211, Japan
Author contributions: Tajiri K and Shimizu Y equally wrote the manuscript.
Conflict-of-interest: The authors have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yukihiro Shimizu, MD, PhD, Gastroenterology Center, Nanto Municipal Hospital, 938 Inami, Toyama 932-0211, Japan. rsf14240@nifty.com
Telephone: +81-763-821475
Received: January 26, 2015
Peer-review started: January 27, 2015
First decision: March 10, 2015
Revised: March 23, 2015
Accepted: May 4, 2015
Article in press: May 4, 2015
Published online: June 21, 2015
Processing time: 144 Days and 20.6 Hours
Abstract

Hepatitis B virus (HBV) infection is still a serious worldwide problem, and vaccination is the most effective strategy for primary prevention of the infection. Although universal vaccination may be required for total eradication, several countries, including Japan, have not yet adopted universal vaccination programs. Some individuals are non-responders to HBV vaccine and several mechanisms responsible for their poor response have been proposed. To overcome non-response, third generation vaccines with pre-S proteins have been developed. These vaccines have shown better anti-HBs responses and may also be effective in preventing infection by HBV with S mutant. Improvement of vaccine efficacy by intradermal administration, or co-administration with cytokines or adjuvants, may also be effective in non-responders. The necessity, timing and method of booster vaccination in responders with decreased anti-HBs responses, and effective vaccination against S-mutant HBV, are issues requiring resolution in the global prevention of HBV infection.

Keywords: Escape mutant; Immunology; Hepatitis B virus vaccination; Non-responder; Universal vaccination

Core tip: Hepatitis B virus (HBV) infection is still a serious worldwide problem, and vaccination is most effective for primary prevention of infection. This review summarizes current unsolved issues and future perspectives on vaccination required for global prevention of HBV infection.