title: Unsolved problems and future perspectives of hepatitis B virus vaccination.
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.
authors.affiliation: Kazuto Tajiri, Department of Gastroenterology, Toyama University Hospital, Toyama 930-0194, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tajiri
authors.affiliation: Kazuto Tajiri, Department of Gastroenterology, Toyama University Hospital, Toyama 930-0194, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D005838:Genotype; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000235:genetics; D017325:Hepatitis B Vaccines / Q000009:adverse effects*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D009154:Mutation; D010641:Phenotype; D011498:Protein Precursors / Q000235:genetics; D016896:Treatment Outcome; D014611:Vaccination / Q000009:adverse effects*
chemical_list: D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D011498:Protein Precursors
keywords: Escape mutant; Hepatitis B virus vaccination; Immunology; Non-responder; Universal vaccination