President Donald Trump is incorrect in characterizing Hepatitis-B as a sexually-transmitted disease and also wrong for suggesting that Hep-B vaccines be delivered in pre-adolescence rather than birth, said hepatologist Dr. Maurizio Bonacini.
The most common transmitter of Hepatitis-B — a virus that infects the liver and can cause cancer or cirrhosis — is mother to child transmission, said Bonacini, speaking at a Sept. 26 American Community Media news briefing. “A mother is very highly viremic. Typically, she doesn’t know it. And then she’ll transmit to the baby.”
”The problem with this is that a baby that doesn’t have any protection at birth, and if it gets hepatitis B, it essentially will keep the hepatitis B for life, about 90%. Whereas if you give a birth dose vaccine, you can decrease that to the single digit number. So it makes a big difference,” said Bonacini, CEO of Mission Gastroenterology and Hepatology and associate clinical professor at the University of California, San Francisco.
“If you vaccinate babies at birth, and then you give them the three doses of vaccine to finish in the first few months of life, you very much decrease the chance of liver cancer,” he stressed.
‘Silent Killer’
Hepatitis-B is often called the “silent killer,” as people infected with the virus are unlikely to know until they are stricken with a disease of the liver. The virus is particularly prevalent in South and East Asian communities. But as vaccines are introduced, infection rates have dropped, said Bonacini.
Previously in mainland China, about 8 to 10% of the population at large was infected with Hep-B. Now that rate has dropped to 4%. Immigrants from India have an estimated 4% carriage rate, noted Bonacini, who has been conducting outreach with the South Asian American community to make them aware of the illness.
The disease currently has no cure. However, if the infection is identified early, a daily drug regimen can keep the virus under control and lessen the chances of liver damage.
Trump’s Recommendations
Hepatitis B is 100 times more infectious than HIV, notes the Children’s Hospital of Philadelphia. Prior to the introduction of the Hep-B vaccine in 1991, about 18,000 each year in the US would become infected by the age of 10; 90% would carry the disease for life. But last year, just 20 children in the US were reported to be born with the infection.
At a Sept 21 press conference — alongside Health and Human Services Secretary Robert F. Kennedy, Jr., National Institutes of Health director Dr. Jay Bhattacharya, FDA Commissioner Marty Makary, and Dr Mehmet Oz, Administrator for the Centers for Medicare & Medicaid Services — Trump declared: “Hepatitis B is sexually transmitted. There’s no reason to give a baby that’s almost just born Hepatitis B.”
“So I would say, wait till the baby is 12 years old and formed and take Hepatitis B. And I think if you do those things, it’s going to be a whole revolution in a positive sense in the country,” stated the President.
The Advisory Committee on Immunization Practices, which met Sept. 18-19, was expected to issue new guidelines on the Hep-B vaccine, overthrowing the current protocol of vaccination at birth. However, ACIP has delayed its recommendations.
Testing
Bonacini noted current Centers for Disease Control and Prevention recommendations, which advise all adults between 19-59 to get tested for Hepatitis-B, using a three-prong strategy.
“I just came back from this meeting in Accra, Ghana, where people don’t get tested because they don’t have money. Well, in the United States, we don’t get tested because we ignore the problems.”
“So it’s a worldwide issue. And the World Health Organization’s goal of viral hepatitis elimination by 2030, unfortunately, is not going to be achievable, neither here in the United States, a resource-rich country, or in developing countries as well,” said Bonacini. He noted that the US is poised to lag behind the developing world.
